QuestionSBA
QuestionChoice
Chest pain, hypoxia, and breathlessness should raise suspicions of myocardial infarction. However, in the absence of ischaemic changes and the presence of right heart strain make pulmonary embolism more likely.
10035393
b
Non-ST elevation myocardial infarction (NSTEMI)
QuestionChoice
Chest pain, hypoxia, and breathlessness should raise suspicions of myocardial infarction. However, in the absence of ischaemic changes (such as ST-segment elevation) and the presence of right heart strain make pulmonary embolism more likely.
10035394
c
ST-elevation myocardial infarction (STEMI)
QuestionChoice
The ECG shows right bundle branch block and right axis deviation, suggestive of right heart strain. This, combined with the patient's hypoxia, chest pain, and recent surgery, makes pulmonary embolism the most likely diagnosis.
10035392
a
Pulmonary embolism
QuestionChoice
Pneumonia is an important differential, however, this does not account for the ECG features of right heart strain or the lack of examination findings; pneumonia would usually cause focal crackles. Pulmonary embolism is the most likely diagnosis.
10035396
e
Hospital-acquired pneumonia
QuestionChoice
While atelectasis can cause post-operative hypoxia, this is usually present earlier in the postoperative course and is milder/less acute. The ECG findings of right heart strain, along with chest pain and hypoxia, make pulmonary embolism the most likely diagnosis.
10035395
d
Atelectasis
QuestionComment
looked at this and thought it was S1Q3T3. Right answer for wrong reason
51934
QuestionComment
i think it's both
61993
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Vaccine Complement
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Dominant Chronic
Concept
Chapter
2693
5916
Right heart strain
Topic
134
Cardiology
19482
Pulmonary embolism should be suspected in post-operative patients presenting with hypoxia, chest pain, and signs of right heart strain on ECG.
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A medical emergency team attends to a patient with breathlessness a week after surgery. They report feeling very unwell and complain of central chest pain. Examination is unremarkable.

Observations:
* Heart rate: 134 beats/minute
* Blood pressure: 102/69 mmHg
* Respiratory rate: 17 breaths/minute
* Temperature: 36.7 degrees
* Oxygen saturations (room air): 89%

ECG:

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a