Author: Akbar Shareef Babar / Editor: Stephen Sheridan / Codes: ResC10, RP3, SLO1, SLO3, SLO7, VC3 / Published: 27/03/2026
A 44-year-old male is brought into Resus after collapsing. He reports sudden-onset chest tightness and sweating, preceded by progressive shortness of breath over the past 24 hours.
On waking up, he notices pain and swelling in his left leg. His brother calls NHS 111, and paramedics find him tachycardic and requiring high-flow oxygen to maintain saturation.
In the Emergency Department (ED), a rapid ABCDE assessment reveals he is breathless at rest and hypoxaemic despite high-flow oxygen. His vital signs are:
- HR: 110 bpm
- SpO₂: 90% on 15 L/min O₂
- BP: 123/93 mmHg
- RR: 28 bpm
- Temperature: 36.9 °C
His past medical history includes sciatica, limiting his mobility. He lives with his brother and struggles to mobilise due to pain.
ECG shows sinus tachycardia with a right bundle branch block pattern. Troponin is mildly elevated, and chest X-ray demonstrates mild bilateral hilar congestion.
6 responses
Great revision
Great Revision
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Very good revision
This is timely for my clinical learning. Informative, detailed, and highlights differences accross various diagnostic and treatment approaches.
Good every day reminder