• J Alberto Neder, Daniel M Hirai, Joshua H Jones, Joel T Zelt, Danilo C Berton, and Denis E O'Donnell.
• Laboratory of Clinical Exercise Physiology and Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Ontario, Canada. Electronic address: alberto.neder@queensu.ca.
• Chest. 2016 Jul 1; 150 (1): e23-7.

AbstractA 56-year-old white woman was referred to the pulmonary clinic for evaluation of unexplained shortness of breath. She enjoyed good health until 3 months prior to this visit when she reported experiencing recurrent episodes of shortness of breath and oppressive retrosternal chest discomfort with radiation to the neck. Episodes lasting 5 to 10 min often occurred at rest and were inconsistently related to physical activity. These symptoms became progressively worse and were often associated with light-headedness and presyncope. Her past medical history was uneventful apart from a prior diagnosis of breast cysts and suspected prolactinoma. Her symptoms escalated to such a level that she was forced to seek urgent medical attention at our institutional ED on two separate occasions in the preceding weeks. These visits precipitated a number of investigations and, eventually, a referral to the pulmonary clinic.Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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