A 45-year-old man with thrombophlebitis of the deep veins in his legs suddenly after physical exertion developed sharp pain in his thorax on the right, dyspnea, and hemoptysis. Objectively his condition is severe; he presents with acrocyanosis, shortening of pulmonary percussion sound on the right, and weakened respiration. Respiration is 30/min., blood pressure is 110/80 mm Hg ECG shows sinus tachycardia, heart rate is 120/min., electric axis of the heart deviates to the right, S1-Q111. What is the most likely diagnosis?

Answer options

1. Community-acquired right-sided pneumonia
2. Cancer of the right lung
3. Right-sided exudative pleurisy
4. Pulmonary embolism
5. Spontaneous pneumothorax

Explanation

Thrombophlebitis, deep vein thrombosis in the leg, usually leads to chest pains through a process called pulmonary artery embolism. Pulmonary embolism (PE) is a blockage of an artery in the lungs by a substance that has moved from elsewhere in the body through the bloodstream (embolism). Symptoms of a PE may include shortness of breath, chest pain particularly upon breathing in and coughing up blood.