A 35-year-old man presented to a Veterans Affairs (VA) pulmonary clinic with dyspnea and cough. The patient's symptoms began 4 years before presentation and had proerans gressed over time. Two years before presentation, he had attempted to enroll in police academy but was unable to complete the required physical training regimen. He reported shortness of breath, cough, and burning retrosternal chest pain that occurred with any degree of exertion but was most pronounced while he was running. He noted that these symptoms never occurred at rest. He reported that he was embarrassed about his inability to exercise and asked why he could no longer keep up with his peers. He was previously evaluated for these symptoms at another clinic, where he had been told he might have asthma. He received a prescription for inhaled albuterol for use before exercise, but his cough and shortness of breath continued to worsen despite this treatment. [ABSTRACT FROM AUTHOR]