title: A 46-year-old woman with left shoulder pain and worsening dyspnea.
abstract: A 46-year-old woman presented with worsening dyspnea and palpitations for 3 days following an episode of left shoulder pain. The patient had received a diagnosis of patent ductus arteriosus with Eisenmenger syndrome in childhood but had been inconsistently taking digoxin and diuretics since then. She was married but had never been pregnant. Over the previous 2 to 3 years, her exercise capacity had decreased significantly, with frequent episodes of near syncope and chest pain. She had developed bilateral leg edema. Three days prior to admission, she noticed an episode of severe, sharp pain in her left shoulder that was nonradiating but associated with palpitations and sweating and that lasted for about 20 min. The shoulder pain subsided spontaneously but her dyspnea worsened significantly, which prompted her to present to the ED.
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Beijing Anzhen Hospital, The Capital Medical University, Beijing, China. Electronic address: liushuang862002@163.com.
authors.forename: Shuang
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Beijing Anzhen Hospital, The Capital Medical University, Beijing, China.
authors.forename: Xiaoyun
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Interventional Radiology, Beijing Anzhen Hospital, The Capital Medical University, Beijing, China.
authors.forename: Xiaoyong
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Interventional Radiology, Beijing Anzhen Hospital, The Capital Medical University, Beijing, China.
authors.forename: Tiezheng
authors.initials: T
authors.lastname: Li
authors.affiliation: Department of Ultrasound, Beijing Anzhen Hospital, The Capital Medical University, Beijing, China.
authors.forename: Ya
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Pulmonary and Critical Care Medicine, University of Southern California Los Angeles, Los Angeles, CA.
authors.forename: Renli
authors.initials: R
authors.lastname: Qiao
mesh_terms: D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging* / Q000628:therapy; D000792:Angiography; D006328:Cardiac Catheterization; D004417:Dyspnea / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D020069:Shoulder Pain / Q000209:etiology*