# The Parallel World of Dyspnea: A Case Report

## TL;DR

A patient with unresponsive dyspnea was eventually diagnosed with myasthenia gravis after new symptoms prompted further investigation.

## Contribution

Highlights the importance of reevaluating diagnoses when symptoms persist or new signs appear.

## Key findings

- Initial treatment for heart dysfunction failed to resolve the patient's dyspnea.
- Ptosis led to the consideration of neuromuscular diseases.
- Myasthenia gravis was diagnosed after expanded clinical and laboratory investigations.

## Abstract

Dyspnea can be found as a symptom of a wide range of diseases. Clinical thinking usually leads us to more common or frequent syndromes and diseases. This case report alerts us to keep investigating when faced with therapeutic failure or the arising of new symptoms. The subject in this case had dyspnea as an initial presentation of his disease and was treated initially as a case of heart dysfunction. Nevertheless, because his symptoms did not respond to the treatment and even got worse, he was sent to the emergency room where he was medicated and discharged with the same diagnostic hypothesis. In light of a new characteristic symptom - ptosis - the hospital team expanded its clinical and laboratory investigation to neuromuscular diseases, reaching out the diagnosis of myasthenia gravis.