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February 13, 1987

Pseudopneumothorax: A Migratory Mirage

JAMA. 1987;257(6):780-781. doi:10.1001/jama.1987.03390060070019

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To the Editor—  I recently saw a patient in consultation who presented with a perplexing combination of roentgenogram findings and a clinical diagnosis of "migratory pneumothorax."

Report of a Case.—  A 70-year-old woman with a long history of angina pectoris was brought to the emergency department complaining of left-sided chest pain, which was relieved by sublingual nitroglycerin. On examination, she appeared as a thin, anxious woman in no distress. Her blood pressure, pulse, and respiratory rate were normal. Breath sounds were symmetrical and normal. Heart tones were normal and the rate irregular. A portable chest roentgenogram disclosed what appeared to be a left-sided pneumothorax. Because this was not consistent with her clinical findings, the roentgenogram was repeated. This time the left-sided pneumothorax had disappeared, but a right-sided pneumothorax had developed! The Figure is a composite of the two portable chest roentgenograms, showing what appears to be a left-sided and a