A 33-year-old female presenting with abdominal pain, shortness of breath, and shoulder pain should be evaluated for which condition?

The presentation of abdominal pain, shortness of breath, and shoulder pain in a 33-year-old female raises strong suspicion for an ectopic pregnancy. Ectopic pregnancies occur when a fertilized egg implants outside the uterus, most commonly in the fallopian tube. This can lead to serious complications, such as rupture, which can result in internal bleeding and may present with symptoms like shoulder pain due to diaphragmatic irritation if there is significant bleeding.

The combination of shortness of breath can indicate that there may be blood intruding into the abdominal cavity, leading to hemoperitoneum, which can irritate the diaphragm and refer pain to the shoulder (Kehr’s sign). The typical presentation of an ectopic pregnancy also includes abdominal or pelvic pain, which aligns with the symptoms described.

Recognizing the urgency of ectopic pregnancy is critical, as this condition can rapidly escalate in severity, necessitating prompt medical intervention.