• Ajay Kundu, Nitesh Gupta, Rohit Kumar, Pranav Ish, Manu Madan, Rajnish Kaushik, and A J Mahendran.
• Department of Pulmonary Medicine, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
• Chest. 2025 Jan 1; 167 (1): e5e8e5-e8.

AbstractA 23-year-old man presented to the ED with a history of respiratory distress, cough, and fever for 10 days. He was evaluated in the ED, where he received a diagnosis of pulmonary edema, secondary to mitral regurgitation with mitral valve prolapse syndrome. He was treated with antibiotics and diuretics and discharged to home. Three months later, he returned to the ED with similar complaints, for which he was treated symptomatically and discharged. After 4 months, the patient once again appeared with worsening respiratory distress and cough with fever. The dyspnea was not accompanied by orthopnea, pedal edema, or palpitation. The patient was admitted to the medical ICU. He had no history of arthralgia, myalgia, skin rash, or other signs of autoimmune disease. He denied any history of smoking, work-related or occupational exposures, drug intake, or recent travel.Copyright © 2024 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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