A 52-year-old businessman with nephrotic syndrome after a non-stop flight from New York to New Delhi presents with sudden onset of breathlessness, haemoptysis, and chest pain. He is brought into Casualty in shock. His chest X-ray is normal. The ECG shows sinus tachycardia.
Correct Answer: Pulmonary embolism
Description: 1. In this patient no pulmonary edema, MI absent and aoic dissection also absent. 2. Nephrotic syndrome patient will be in hypercoagulable state, long flight- DVT- pulmonary embolism- acute Cor pulmonale 3. Most common causes of Cor pulmonale- pulmonary embolism 4. CXR is normal because it is only a small clot and clot usually not visible on X-ray
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