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Radiology
Case-A 42-year-old Female with Chest Pain
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Vadim Vaisman, MD
The patient is a 42-year-old African American female who presented to the emergency department complaining of acute chest pain. She described it as severe, sharp and pleuritic in nature, without radiation and located mostly on the right side of her chest. The patient reported progressive shortness of breath for two weeks with several episodes of paroxysmal nocturnal dyspnea. She returned from a long car trip approximately 2 weeks prior to this episode. Her past medical and surgical history was only significant for genital herpes and a cessarean section 19 years ago. Her family history was significant for a deep venous thrombosis on the maternal side. The patient smoked half a pack of cigarettes a day for approximately 20 years. Her vital signs were within normal limits, except for mild tachypnea. The physical exam was unremarkable. Laboratory studies, including a basic metabolic profile, complete blood count, arterial blood gas and cardiac enzymes were all within normal limits.
Chest X Rays and CT of the chest are shown below. What is the diagnosis?
Figure
1. Chest X-Ray PA view (click to view larger version)
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2. Chest X-Ray Lateral view (click to view larger version)
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3. CT chest (click to view larger version)
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