PLE-4282

PLE-4282

A 22-year-old primigravid woman, at 16 weeks’ gestation, is brought to the emergency department because of progressive shortness of breath over the past 48 hours. Her temperature is 37°C (98.6°F), blood pressure is 120/70 mm Hg, pulse is 100/min, and respirations are 24/min. Scattered wheezes are heard. Pelvic examination shows a uterus that extends to the umbilicus. Her hematocrit is 32%, leukocyte count is 11,000/mm3, and serum β-hCG level is 300,000 mIU/mL. Pulse oximetry on room air shows an oxygen saturation of 92%. An x-ray film of the chest shows multiple round densities throughout all lung fields. What is the most likely diagnosis?