A patient presents to the ER with shortness of breath and JVD during exhalation. What underlying problem should the therapist suspect?

In this case, the presence of shortness of breath and jugular venous distention (JVD) during exhalation suggests a problem primarily related to restricted airflow and potential right heart failure or volume overload. These symptoms are often indicative of obstructive lung disease, as this condition can lead to increased pressure in the thoracic cavity during exhalation, which then affects venous return and causes JVD.

Obstructive lung diseases, such as chronic obstructive pulmonary disease (COPD) and asthma, involve narrowing of the airways that leads to difficulty in exhaling air, resulting in trapping of air in the lungs. This air trapping increases lung volumes, which can impact the cardiovascular system and lead to complications such as JVD. In situations where the lungs are hyperinflated, the pressure changes can significantly affect venous return from the right side of the heart, causing the observed jugular venous distention.

Other options, while related to respiratory issues, do not typically present with both shortness of breath and JVD during exhalation. Asthma, for instance, primarily involves wheezing and airway constriction, but JVD is not a common feature. Interstitial lung disease often presents with dry cough and progressive short