Prepared by Paul Strachan, MD, Fellow, Walter Chua, MD, Fellow, and Eric Gottesman, MD, Attending Physician, Division of Pulmonary, Critical Care and Sleep Medicine, Long Island Jewish Medical Center, New Hyde Park, NY

A 64-year-old woman with a history of chronic obstructive pulmonary disease (COPD) presented to the emergency department complaining of a few hours’ duration of substernal chest pain and dyspnea. Chest x-rays were performed (Figure).

What’s the Diagnosis?

• Tension pneumothorax
• Hyperlucent lung syndrome
• Single lung transplant
• Bronchopulmonary dysplasia