查看文章

A36-year-old woman presented to the hospital for evaluation of progressively worsening dyspnea on exertion. She had a pertinent medical history of anxiety, polycystic ovary syndrome, and rheumatoid arthritis work-up with her primary care provider. Her home medications included escitalopram, gabapentin, glucosamine-chondroitin, loratadine, multivitamin, acetaminophen, and ibuprofen. She reported 2 weeks of progressively worsening dyspnea on exertion with associated nonproductive cough, chills, sore throat, and palpitations. She denied any orthopnea or peripheral edema, but was unable to perform daily activities without dyspnea. She reported recent home pulse oximetry readings down to 90% at rest and 67% with ambulation.

Upon arrival to the hospital, her physical examination revealed that the patient was afebrile and in no acute distress, with head, eyes, nose and throat within normal limits, heart with …