A 79-year-old woman has a history of shortness of breath, bronchial asthma, and bronchiectasis associated with recurrent episodes of bronchitis and pneumonia.

She developed left upper anterior pleuritic chest pain. Her blood pressure was 143/75 mm Hg, pulse was 105 beats per minute, respiration was 18 breaths per minute, and O₂ saturation is 98% on room air. Her chest x-ray showed new small bilateral pleural effusions. White blood cell count was 7100 cells/ml, hemoglobin was 11.5 gr/dl, natriuretic peptide assay was 637 pg/ml, and troponin was 0.43 µg/L. The electrocardiogram (ECG) demonstrated inverted T waves over the anterior precordium (Fig. 73-1).