Hypoxemia, cerebrovascular accident, and a chest mass in a 78-year-old woman.

A 78-year-old woman was referred for evaluation of a chest mass. She described progressive dyspnea on exertion over the past several years that she attributed to deconditioning. She had an occasional cough productive of a minimal amount of clear to yellow sputum. She denied wheezing, paroxysmal nocturnal dyspnea, hemoptysis, fever, chills, or weight loss. She also denied chest pain and had no history of coronary artery disease. She had been admitted to the hospital in March 1996 for cataract surgery and was noted to be hypoxemic. She had normal findings from an evaluation for coronary artery disease, including an echocardiogram, which did not show an intracardiac shunt. In January 1997, she was admitted to the hospital for evaluation and management of an embolic cerebrovascular accident. She did not have carotid artery disease. She was a former smoker but quit 30 years ago.