He has a past history of chest pain episodes, usually at night while sleeping in bed. He is alert and active in no distress. He is tall and thin. Heart regular, no murmurs. Lungs clear, but diminished breath sounds bilaterally.
Peripheral pulses are full.
Color and perfusion are good. A chest radiograph is ordered. This CXR shows a long thorax with hyperexpanded lungs. The aortic shadow is not obviously widened. The cardiac silhouette is not enlarged.