A 50-year-old woman with a history of asthma presented to the emergency department with chest pain and worsening dyspnea. Approximately 1 year before presentation, intermittent episodes of nonradiating chest tightness and shortness of breath had developed. Pulmonary function testing was consistent with asthma. She was treated with inhaled glucocorticoids and albuterol and had some abatement of symptoms. One week before presentation, worsening shortness of breath had developed, which she thought was related to her asthma. She had recently received her third dose of a messenger RNA (mRNA) vaccine for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), although she was not certain about the precise temporal relationship to the onset of symptoms. Despite treatment with escalating doses of inhaled glucocorticoids and inhaled albuterol, her symptoms progressed. On the day of presentation, pleuritic chest pain developed, which radiated to the back and was worsened by exertion but not by positional changes. She reported no orthopnea, paroxysmal nocturnal dyspnea, dyspnea when bending forward, fevers, chills, night sweats, weight changes, myalgias, arthralgias, rashes, wheezing, anosmia, dysgeu-sia, or ageusia.
Ryan A. Denu、Daniel H. Solomon、Richard N. Mitchell、Yee-Ping Sun、Joseph Loscalzo
展开 >
Departments of Medicine and Pathology, Brigham and Women's Hospital, Boston.
NSTL
Massachusetts Medical Soc
