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History A 25 year old white female reports to the Emergency Room because of sharp left sided
chest pain and shortness of breath of one day duration. The patient was in excellent health until
yesterday. She was awakened from her sleep by sharp left sided chest pain. The pain worsened
with motion and deep breathing. The pain has been progressively increasing in severity and she
now has severe left shoulder pain. She complains of shortness of breath and is very apprehensive
about dying. She denies any cough, fever, sputum production or hemoptysis. She is married and
had one normal delivery three years ago. She is currently on birth control pills. She has never
been hospitalized except for labor and delivery. Review of systems are negative She denies any
past history of venous problems. She reveals having a similar transitory minor episode of chest
pain approximately one year ago while she was vacationing in Michigan. She works as a
computer programmer. She smokes one pack of cigarettes a day for the past eight years. She
considers herself a social drinker. 1. Is the patient dyspneic? What specifically in the report
helped you answer this? 2. Is the patient coughing up blood? What specifically in the report
helped you answer this? Physical Examination Blood pressure 114/80 pulse 118; temperature 37
: 0 (oral) She appears to be in moderate respiratory distress. She is well developed and nourished.
Pertinent findings include a respiratory rate of 30 and shallow breathing There is dullness,
decreased chest expansion and decreased breath sounds in the left base There were no rales or
rubs.

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History A 25 year old white female reports to the Emergency Room becau.docx

  • 1. History A 25 year old white female reports to the Emergency Room because of sharp left sided chest pain and shortness of breath of one day duration. The patient was in excellent health until yesterday. She was awakened from her sleep by sharp left sided chest pain. The pain worsened with motion and deep breathing. The pain has been progressively increasing in severity and she now has severe left shoulder pain. She complains of shortness of breath and is very apprehensive about dying. She denies any cough, fever, sputum production or hemoptysis. She is married and had one normal delivery three years ago. She is currently on birth control pills. She has never been hospitalized except for labor and delivery. Review of systems are negative She denies any past history of venous problems. She reveals having a similar transitory minor episode of chest pain approximately one year ago while she was vacationing in Michigan. She works as a computer programmer. She smokes one pack of cigarettes a day for the past eight years. She considers herself a social drinker. 1. Is the patient dyspneic? What specifically in the report helped you answer this? 2. Is the patient coughing up blood? What specifically in the report helped you answer this? Physical Examination Blood pressure 114/80 pulse 118; temperature 37 : 0 (oral) She appears to be in moderate respiratory distress. She is well developed and nourished. Pertinent findings include a respiratory rate of 30 and shallow breathing There is dullness, decreased chest expansion and decreased breath sounds in the left base There were no rales or rubs.