A breathless woman with asthma

doi:10.1136/bmj.b4008

Published 7 October 2009, doi:10.1136/bmj.b4008
Cite this as: BMJ 2009;339:b4008

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A breathless woman with asthma

Robert H Thomas, specialist registrar in radiology, Christopher Burke, specialist registrar in radiology, David Howlett, consultant radiologist

¹ Eastbourne District General Hospital, Eastbourne BN21 2UD

Correspondence to: R H Thomas roberththomas@gmail.com

The first 150 words of the full text of this article appear below.

A 36 year old housewife presented to the accident and emergencydepartment because of increasing breathlessness, wheeze, andproductive cough over the past two weeks. She had a historyof asthma, which was well controlled with inhalers, but hadno other history of note and was a non-smoker.

On examination, she was dyspnoeic but afebrile, with a prolongedexpiratory wheeze at the left base.

Posteroanterior chest radiography was performed as part of herinitial investigations (fig 1).

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Fig 1 Posteroanterior chest radiograph

1 What radiological abnormality is present?

2 What is themost likely cause considering her history?

3 How would youtreat her?

1 The chest radiograph shows a triangular shadow of soft tissuedensitybehind the heart in the left lower zone. It also showsa lossof clarity in the adjacent descending thoracic aortaand theleft hemidiaphragm in its medial portion, with depressionofthe . . . [Full text of this article]