Case 2

A 57-year-old male smoker attends the ED complaining of 24-hours of sudden onset pleuritic chest pain. He is only coughing a small amount of white sputum (normal for him) and denies a fever. Percussion of the chest is equal bilaterally and on auscultation you identify no wheeze or crepitations. You cannot elicit any chest wall tenderness and the ECG is normal.

His observations are BP 150/90, pulse 90 and regular, O2 sats. 93% on room air, temperature 36.9 degrees Celsius, and respiratory rate (RR) 22. There is no clinical suggestion of a DVT. You request a D-Dimer, a chest radiograph and perform blood gases on room air.