ABSTRACT
A 51-year-old woman presented to the emergency department complaining of shortness of breath. She described suddenly becoming aware of mild shortness of breath 1 week earlier and this had now progressed to the point where she was dyspnoeic on minimal exertion. She had a non-productive cough which had been present for 24 hours. She denied any recent fevers, night sweats or weight loss. She also had a 12-hour history of constant, dull, right-sided chest pain, which was exacerbated by lying flat. She had no recent surgery or episodes of prolonged immobility. Her past history included bilateral osteoarthritis of the knees, for which she had recently been referred to the rheumatology department, and type 2 diabetes mellitus. She took regular 500 mg metformin BD and occasional paracetamol for knee pain. She lived with her husband and worked as a special needs teaching assistant. Neither she nor her husband had ever smoked. She had not travelled abroad in recent years.
