رجل عمره ٦٨ سنة يأخذ أميودارون ٢٠٠ ملغ يومياً منذ سنة للرجفان الأذيني. جاء للعيادة يشتكي من أشياء متعددة. العلامات الحيوية: الضغط ١٢٦/٧٦، النبض ٦٢، التشبع ٩٢٪ (كان ٩٧٪ قبل ٦ أشهر). أي عرض جديد يستدعي إبلاغ الطبيب أكثر من غيره؟

A 68-year-old man has taken amiodarone 200 mg daily for a year for atrial fibrillation. At clinic he has several complaints. BP 126/76, HR 62, SpO2 92% (97% six months ago). Which new symptom most warrants notifying the provider?

1. A slight blue-grey tint to the facial skin
2. A dry cough and gradually worsening breathlessness
3. Sensitivity to sunlight outdoors
4. Mild constipation

Answer: B) A dry cough and gradually worsening breathlessness. The most serious chronic side effect of amiodarone is pulmonary fibrosis, presenting as dry cough and increasing dyspnoea. Skin discolouration and photosensitivity are known and need sun protection, but are less dangerous.