Primigravid Florist With Chest Pain, Cough, and Shortness of Breath

Zab Mosenifar, MD


August 31, 2023

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A 31-year-old primigravid woman at 37 weeks' gestation presents to the emergency department with a 2-day history of left-sided chest pain, nonproductive cough, hemoptysis, and dyspnea at rest, exacerbated by activity. She works part-time as a florist in a garden center. Her pregnancy has been uncomplicated up to this point, with mild acid reflux managed with diet.

She reports no history of pulmonary injury or trauma, nor significant alcohol or past inhaled or injected illicit drug use. The patient quit smoking 5 years ago but was formerly a heavy smoker (10 pack years). Past medical history is remarkable for mild seasonal allergies and recurrent sinusitis but unremarkable for bronchial asthma, bronchiectasis, cystic fibrosis, or chronic obstructive pulmonary disease. Environmental history is unremarkable for exposure to pesticides, fumigants, household cleaning agents, or disinfectant sprays.

Her family history is noteworthy for her father dying from idiopathic pulmonary fibrosis and her mother from ovarian cancer.


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