Author: Leon Wood / Editor: Thomas MacMahon / Reviewer: Emer Kidney / Codes: CC3, CC4, CP2, ResC6, SLO3 / Published: 02/09/2022

An 80-year-old woman is next to be seen. She arrived in the UK 2 days ago, after a flight from Singapore. She had shortness of breath on minimal exertion, with dizziness and near collapse after climbing stairs which is very unusual for her.

She has no chest pain, fevers or flu-like symptoms. She is a non-smoker and has a background medical history of hypertension. Her only regular medication is nifedipine. On your examination, she is alert and pain free.

Her vital signs show a heart rate of 45, blood pressure of 124/67mmHg, temperature of 35.6oC, respiratory rate of 21 and oxygen saturations of 95% on 2 litres. She has no murmurs nor visible JVP. She has crackles at both lung bases. Her calves are non-tender and her abdominal examination is unremarkable.

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