This old man is an old case of asthmatic bronchitis. on treatment. smoker.non diabetic but hypertensive. His both shoulders are exactly horizontal. His chest bony cage has wide intercostal spaces.Please throw more clinical light on this patient.

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SUGGESTIVE. Of BARREL. SHAPED CHEST... DUE. TO..... EMPHYSEMA.... AND HYPERINFLATION. IN. SUCH. PATIENTS.... ....THE. LUNGS. ARE. OVERLOADED. WITH. AIR. ..DUE. TO....BRONCHODILATORS... ....AND. THE. RIB. CAGE. ...STAYS. EXPANDED....FOR. THE. CONTINUOUS. LONG. PERIODS.....
Thank you doctor
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Chest xray. Ecg.