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Welcome back, Clinical Problem Solvers. I'm joined by the wonderful Mani and Noshin today. And Mani, how have you been? I've been doing well. I am super excited to discuss this case today. It'll be a good one.

So before we start, I'm going to introduce our guest today, the amazing Dr. Noshin Reza,

who's our cardiologist and translational researcher at the University of Pennsylvania,

focusing in advanced heart failure and transplant cardiology and cardiovascular genetics. She obtained her medical degree from the University of

Virginia School of Medicine and completed internal medicine residency at the Massachusetts

General Hospital. She then completed both her cardiovascular disease and advanced

heart failure and transplant cardiology fellowships at the University of Pennsylvania. At Penn, Dr. Reza

pursued additional scholarship in genomic medicine as an NIH-D-32-funded post postdoctoral fellow and in healthcare quality as a

Penn Benjamin and Mary Siddens-Mesey fellow in quality improvement and patient safety.

Now, as an assistant professor of medicine, she cares for patients in the Penn Center for

Inherited Cardiovascular Disease and in the Penn Center for inherited cardiovascular

disease and in the section of heart failure, transplantation, and mechanical support.

Dr. Reza is also an assistant program director of the Cardiovascular Disease Fellowship

and the director of the Penn Women in Cardiology Program. Welcome, Noshane.

Hi, so good to be here with both of you. I'm excited to talk about this case. All right, let's go

ahead and get started. So our first Aliquot, we have Mrs. M. She's a 19-year-old. She has no significant past medical history.

She presents with two days of fever in pleuritic chest pain. She was in her usual state of health until two days prior to presentation.

She started having malaise, floridic chest pain, subjective fevers and chills, some leg swelling, and then also had associated headaches.

She hasn't had any sick contacts, no nausea, vomiting, diarrhea, no rash, shortness of breath,

or cough initially. Then two days later, she started having episodes of dysmia when she was

...