A 19-year-old female college student presents to the emergency department complaining of chest tightness and dyspnea. Sh

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A 19-year-old female college student presents to the emergency
department complaining of chest tightness and dyspnea. She was
cutting and trimming the lawn when these symptoms developed.
Rhinorrhea and tearing began soon after she went outside and
preceded the chest discomfort. Going inside did not relieve her
symptoms.
During the physical examination, she said, “I have had asthma
since childhood, and my mother and brother also have asthma.” Her
respiratory rate was 30 breaths per minute, and she exhibited the
use of accessory muscles of respiration. Breath sounds were
decreased, except for expiratory wheezes. Heart sounds were distant
with tachycardia, but regular.