Author: Maria Angela Garcia / Editor: Nick Tilbury / Codes: / Published: 28/06/2022
A 30-year-old male with no significant past medical history presents to the Emergency Department (ED) with shortness of breath and a dry cough for the past two weeks.
The patient explains that his symptoms have increased in severity in the last 4 days and that they are particularly bad on exertion. He reports that the symptoms coincide with his family cleaning up the attic which is next to his bedroom. He is a non-smoker and has no relevant family history. A COVID antigen test is negative.
On examination you note a BMI >35 and on auscultation you hear widespread coarse crackles bilaterally. He has a fast but regular heartbeat with no murmurs and there is mild pitting oedema in the legs.
Observations:
- SpO2 95% on room air
- HR 129
- BP 185/157
- RR 28
- T 36.9 C
His initial ABG:
- PH 7.44
- PO2 7.60
- PCO2 4.66
- HCO3 23.4
- Lac 1.12
His blood results:
- WBC 8.1
- Neu 5.6
- D-Dimer 1149
- CRP 3.51
- Urea 5.2
- Creatinine 99
- Troponin 30
A CXR is performed as shown below.
