A 71-Year-Old Woman Presenting With Abdominal Pain and Dyspnea

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A 71-Year-Old Woman Presenting With Abdominal Pain and Dyspnea Kan Liu, MD, PhD, Debanik Chaudhuri, MD, Arunpreet Kahlon, MD CHEST Volume 152, Issue 4, Pages e81-e84 (October 2017) DOI: 10.1016/j.chest.2017.04.190 Copyright © 2017 American College of Chest Physicians Terms and Conditions

Figure 1 A CT imaging study of the abdomen revealed ischemic bowel perforation (A) secondary to incarcerated hernia (B). CHEST 2017 152, e81-e84DOI: (10.1016/j.chest.2017.04.190) Copyright © 2017 American College of Chest Physicians Terms and Conditions

Figure 2 A, A portable chest radiograph shows bilateral hilar fullness/haziness, diffuse infiltrates, and pleural effusion. B, An ECG revealed an ST-segment elevation myocardial infarction pattern. CHEST 2017 152, e81-e84DOI: (10.1016/j.chest.2017.04.190) Copyright © 2017 American College of Chest Physicians Terms and Conditions

Figure 3 A, A two-dimensional echocardiogram revealed apical akinesis (arrowheads) in an apical two-chamber view. B, A speckle-tracking echocardiogram depicts a unique distribution pattern of abnormal myocardial contractility in a left ventricular 17-segment (bull’s eye) plot. Impaired peak systolic longitudinal strains are highlighted by digital (normal, –17% or lower) and color (red, normal; pink, impaired; blue, significantly impaired) codes. C, A color Doppler study shows a turbulent flow in the left ventricular outflow tract (arrowhead) and simultaneous mitral regurgitation (arrow). D, A continuous-wave Doppler study shows an increased gradient across the left ventricular outflow tract (arrowhead, the first heart beat) and mitral regurgitation (arrow, the second heart beat). CHEST 2017 152, e81-e84DOI: (10.1016/j.chest.2017.04.190) Copyright © 2017 American College of Chest Physicians Terms and Conditions