• Eline G M Steenhuis, Maaike M Brus, Nils A 't Hart, Liudmila L Kodach, Jacqueline Nijboer-Oosterveld, and Benjamin Tomlow.
• Department of Pulmonology, Isala, Dokter van Heesweg 2, Zwolle, The Netherlands. Electronic address: e.g.m.steenhuis@isala.nl.
• Chest. 2022 Apr 1; 161 (4): e233-e240.

Case PresentationA 20-year-old woman presented with dry cough, right-sided thoracic pain, and gradually progressive dyspnea on exertion. She had no hemoptysis or fever. There was no relevant medical history. She was a never smoker and used no medication besides oral contraceptives. There were no other risk factors for a pulmonary embolism. There was a family history of ovarian and breast cancer. Physical examination showed a mildly ill-looking woman, with shallow breathing and normal blood oxygen saturation. Auscultation revealed normal breath sounds without crackles or wheezing. Laboratory testing showed a significantly increased D-dimer (4,560 μg/L [normal, < 500 μg/L]), elevated C-reactive protein (131 mg/L [normal, < 5 mg/L]), normal leucocytes, and elevated lactate dehydrogenase (825 units/L [normal, 50 to 250 units/L).Copyright © 2021 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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