Worth a Second Look-A 49-Year-Old Woman with Progressive Dyspnea

摘要

A 49-year-old woman presented with a 6-month history of shortness of breath. An initial contrast-enhanced computed tomographic {CT) scan of the chest revealed narrowing of the pulmonary artery. This presentation was thought to be due to pulmonary embolism, and the patient was treated with enoxaparin. However, she returned 1 week later with worsening dyspnea despite medication adherence. A 49-year-old woman with a medical history notable only for hypertension was seen at a primary care clinic with complaints of progressive shortness of breath for 6 months. She denied any significant sick contacts, recent travel, or other findings on review of systems.