A 23-Year-Old Woman With Sudden-Onset Dyspnea and Chest Pain Penetrating to the Back*

摘要

A 23-year-old woman with a sudden onset of chest pain and dyspnea presented to the emergency department. Her medical history was significant for multiple rib fractures, tongue laceration, and ankle sprain sustained in a fall in 2005. She had no other pulmonary or cardiac history. Her medication list included a daily oral contraceptive pill and ibuprofen as needed. The chest pain and breathlessness developed suddenly while running on a treadmill. She denied any recent trauma, coughing, wheezing, retching, or vomiting. She had no esophageal complaints. The chest pain was described as sharp, retrosternal in location, and radiating to the back. She also had a sense of air hunger that was partially relieved with deep breaths and complained of intermittent hiccups as well as persistent yawning throughout the day. These symptoms persisted despite resting from strenuous physical activity for the remainder of the day.