The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.
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.
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Cite this: Zab Mosenifar. Primigravid Florist With Chest Pain, Cough, and Shortness of Breath - Medscape - Aug 31, 2023.