Heavy Breathing

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.


  • 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.


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