A
25-year-old white female presents to the emergency room because of sharp
left-sided chest pain and shortness of breath for the past day.
The patient was in excellent health until yesterday.
She was awakened from sleep by the sharp left-sided chest pain.
The pain worsened with motion and deep breathing.
The pain has been increasing in severity and now she has severe left
shoulder pain. She reveals having a
similar, transient episode of chest pain about one year ago while she was
vacationing in Michigan. Presently,
she complains of shortness of breath and is very apprehensive about dying. She
denies any cough, fever, or sputum production, but has had one episode of
hemoptysis earlier today and, upon further questioning, notes some swelling and
tenderness of the left calf. She is
married and had one normal delivery three years ago.
She is taking birth control pills.
She has never been hospitalized except for delivery of her first child.
The patient does recall having a left ankle fracture 6 years ago with a
cast in place for 6 weeks. A review
of systems is negative. She denies
any history of venous problems. She works as a computer programmer.
She has smoked one pack of cigarettes a day for the past eight years.
She considers herself a social drinker.