查看文章

CASE PRESENTATION A 49-year-old woman was referred to Mayo Clinic for a 10-year history of progressive shortness of breath. Initially this was attributed to depression because when her depression was well-medicated, her shortness of breath improved. However, for several months prior to presentation, her shortness of breath worsened, and she had frequent, severe, pounding headaches upon awakening. When evaluated, the patient was short of breath even at rest. Lying down or minimal physical activity worsened her dyspnea. She was unable to work because of her symptoms. She also noted progressive weakness affecting her legs more than her arms. She had difficulty to rising from the floor. She had no ptosis, diplopia, dysphagia, numbness, paresthesias, neck or shoulder pain, muscle cramps, or fasciculations. She had a 30-pack-year history of smoking but had not smoked for 15 years prior to …