A 43-year-old Vietnamese-American woman was referred for evaluation of dyspnea. Six months prior to presentation, left-sided chest pain radiating to her shoulder had developed, and she also noted nonproductive cough and decreased exercise tolerance. These symptoms resolved spontaneously after 10 days, and she returned to her usual state of good health. Within a few weeks began the insidious onset of progressive exertion-related dyspnea. She denied fevers, night sweats, weight loss, cough, sputum production, hemoptysis, wheezing, or recurrent chest pain. She was seen by her primary care physician who started her on loratadine, 10 mg/d, and albuterol by metered-dose inhaler. When her symptoms failed to improve, she was referred to our institution.