Case 2-2016: An 84-Year-Old Woman with Chest Pain, Dyspnea, and a Rash

An 84-year-old woman was admitted to the hospital because of chest pain, respiratory distress, and a purpuric rash. Initial chest imaging showed bilateral patchy and confluent opacities, a finding consistent with pulmonary edema. A diagnostic procedure was performed. Presentation of Case Dr. Omar Kattan (Medicine): An 84-year-old woman was admitted to this hospital because of chest pain, dyspnea, and a rash. The patient had been in her usual health and able to perform normal activities of daily living (including walking one block) until 3 days before admission, when fatigue, anorexia, nausea, and dry heaves developed. On the day of admission, substernal chest discomfort occurred; she awoke in the late evening with pain in the upper chest that she rated at 5 on a scale of 0 to 10 (with 10 indicating the most severe pain), with associated tightness, . . .