Raul Hernandez

A 64 year-old woman with past medical history of diabetes mellitus type 2 that is well-controlled on insulin, hypertension, and asthma presents with 1 week of shortness of breath and cough productive of blood-tinged sputum. The shortness of breath became suddenly worse about an hour ago as she was walking into your emergency department for evaluation and at that time she had symptoms of pre-syncope. She is denying chest pain, palpitations, diaphoresis, nausea, recent travel, or surgery. The patient takes both a beta-blocker and a calcium channel blocker to control her hypertension. She took all of her medications this morning prior to presentation. The patient has no personal history of cancer and there is no significant family history. She denies the use of tobacco, alcohol, or any other drugs.