Author: William Wilson, Gokul Sagar Bailur / Editor: Sarah Edwards / Codes: / Published: 06/10/2025
A 54-year-old man presents to the emergency department (ED) with acute onset shortness of breath and chest discomfort that began suddenly while watching television.
He describes the pain as a dull pressure in the centre of his chest, worsening when lying flat and relieved by sitting forward. He reports feeling lightheaded and notes some swelling in his legs over the past week. His past medical history includes metastatic lung cancer, currently on chemotherapy.
On examination, His blood pressure is 92/60 mmHg, heart rate 118 bpm, respiratory rate 24/min, and oxygen saturation 86% on room air. Heart sounds are muffled. Peripheral pulses are weak and there is mild bilateral ankle oedema. Lungs are clear to auscultation.
On examination:
He appears anxious and diaphoretic.
Pulse 118, BP 88/50mmHg, RR 27/min and spO2 89 RA
CVS- S1 S2 heard. No murmurs.
RS- reduced air entry at the bases, otherwise normal
