ABSTRACT
A 24-year-old woman presented to the emergency department complaining of a 2-week history of nausea, vomiting and shortness of breath on exertion. She also reported a 1-week history of cough productive of blood-stained sputum. When asked about her general health, she described episodes of diplopia that were becoming increasingly frequent and an intermittent sensation of chest discomfort (‘heaviness or pressure on my chest’) that was worse at night. She denied experiencing weight loss or fevers. She had no past medical history and her only medication was the combined oral contraceptive pill. She worked as a data analyst and lived with her parents. She had never smoked, drank around 5 units of alcohol per week and denied recreational drug use. She had only travelled to Italy in childhood.
