The patient came to Austria as a refugee during the Yugoslav Wars 25 years ago. She was in the 7th week of pregnancy when her husband brought her to the emergency room (ER) of the Graz University Medical Center at 3 o'clock in the morning due to increasing dyspnea. She also complained of a dry cough but there was no fever. She had had a miscarriage 7 months previously and 3 years earlier, the patient had had a cesarean section at 40 weeks of gestation due to fetal distress. A healthy infant was delivered, weighing 3290 g and measuring 52 cm in length. At that time the hemoglobin before the cesarean section was 11.0 g/dL (normal: 12.0-15.3 g/dL), the mean corpuscular volume (MCV) was 82.8 fL (normal: 80-98 fL) and hemoglobin after delivery was 9.2 g/dL. On the current admission, she did not complain of any pain