Cardiovascular
Case 9: A Fit Woman with Shortness of Breath and Flu‐Like Symptoms
CASE
A 22‐year‐old woman, who is a keen long distance runner and usually extremely fit and well, has been brought into the A&E department. Since yesterday she has been becoming increasingly short of breath. It is considerably worse today. She had been unwell with a flu‐like illness and fever over the last week or so, but had still been able to train until a few days ago. She also has mild central chest discomfort.
On examination she appears distressed, unwell and clearly short of breath. Her respiratory rate is 34 breaths/min, BP 88/50 mmHg, and pulse is 140 beats/min sinus tachycardia. Her temperature is 38.5°C and SpO2 is 89% with an oxygen reservoir bag and mask. Her jugular venous pressure (JVP) is raised to the ear and there are loud heart sounds including a third heart sound. There is no peripheral oedema. There are widespread fine inspiratory crackles. And the percussion note is resonant. Troponin I is −0.9
QUESTION 1
Your score this session: 0 of 0
What is the most likely cause of her symptoms?