Case 9-2014: A 34-Year-Old Woman with Increasing Dyspnea

A 34-year-old woman with a history of Raynaud's phenomenon and symmetric joint pain was admitted to the hospital because of increasing dyspnea. An echocardiogram showed severe pulmonary hypertension. Diagnostic test results were received. Presentation of Case Dr. Lauren D. Moore (Medicine): A 34-year-old woman was admitted to this hospital because of increasing dyspnea. The patient had been well until approximately 4 months before admission, when shortness of breath developed. Approximately 3 months before admission, she began to awaken at night with chest tightness associated with fever, coughing, and dyspnea on exertion. She was evaluated in the emergency department at another hospital. A chest radiograph reportedly showed abnormalities in the lower lobe of the left lung, and a diagnosis of community-acquired pneumonia was made; oral antibiotics were administered. Increasing dyspnea and cough developed 2.5 . . .