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.

1She has pleuritic pain. What are the characteristics of pleuritic pain?

2Is her pain due to visceral or parietal pleural inflammation?

3 What is the differential diagnosis of pleuritic pain?

4 List diagnoses that could fit the history of this patient as an etiology for pleuritic pain.

Physical Examination

Additional Studies