Abstract

A 47-year-old woman of Italian descent with a history of transfusion-dependent β-thalassemia intermedia presented to the emergency department with dyspnea that had worsened during the previous several days. The physical examination revealed 28 respirations per minute, a heart rate of 113 beats per minute, normal oxygenation while the patient was receiving supplemental oxygen, clear lungs, and jugular venous distention. Laboratory analyses showed a hemoglobin level of 4 g per deciliter and a hematocrit of 15%. Chest radiography (Panel A, arrow) and computed tomography (Panel B, arrow) show enlarged central pulmonary arteries owing to pulmonary arterial hypertension. In patients with thalassemia, . . .

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