October 2014

A middle-aged man presents with exertional hemoptysis to your clinic. There is no associated chest discomfort with activity. At rest, he has no complaints. His exam is significant for a normal HR and BP and a normal lung exam. His cardiac exam is notable for a gallop. No murmurs are appreciated. A pulmonary evaluation including PFTs and CT PE protocol are negative.

This is a 23-year-old female admitted for the first time who provides the history of congenital right chest wall deformity, right hypoplastic breast and absent right pectoralis muscles (1). Preliminary upright PA, lateral and right posterior oblique radiographs were obtained to evaluate the osseous and soft tissues of the thorax prior to cosmetic surgery and repair. No past history was made available.