TY -的T1 - 49岁的女性进步气短JF -神经学乔-神经病学SP - 830 LP - 836 - 10.1212 / WNL。首页0 b013e31820e7c0d六世- 76 - 9 AU -安东尼·A·阿马托AU -安德里亚·n则Hunderfund盟Duygu Selcen AU - b .马克Keegan Y1 - 2011/03/01 UR - //www.ez-admanager.com/content/76/9/830首页.abstract N2 - 49岁的女性被称为梅奥诊所的10年历史进步的气短。最初这是归因于well-medicated抑郁,因为当她的抑郁症,她呼吸急促改善。然而,几个月前的演讲中,她的呼吸急促恶化,和她频繁,严重的头痛在觉醒。当评估,病人呼吸急促即使在休息的时候。躺着或最小的物理活动加剧她的呼吸困难。她不能工作因为她的症状。她还指出进步疲软影响她的腿比她的手臂。她从地板上有困难。她没有下垂,复视、吞咽困难、麻木、感觉异常、颈部或肩部疼痛,肌肉痉挛,或束状。 She had a 30-pack-year history of smoking but had not smoked for 15 years prior to presentation. She denied asthma, wheezing, cough, previous deep vein thrombosis or pulmonary embolism, recurrent lung infections, or any other pulmonary problems. Her mother had type 2 diabetes mellitus. Two maternal aunts were known to have cardiomyopathy, though the details were unknown. General examination showed an obese patient (body mass index 36.7) on 2 L of oxygen by nasal cannula. Inspiratory effort was poor with audible fine crackles on deep inspiration. She had paradoxical breathing in the supine position. A grade 2/6 systolic heart murmur was present along both sides of the sternum. There was no peripheral edema. Neurologic examination revealed normal mental status. Cranial nerve examination including funduscopy was normal. There was mild, symmetric weakness of the deltoid, biceps, and iliopsoas muscles bilaterally. Muscle stretch reflexes were normal, plantar responses were flexor, and muscle tone was normal. Pain and joint position sense were normal. She was able to rise from sitting without using her arms. She was able to walk on heels and toes … ER -