The Author suggests that the Lesson from this case is that wider
recognition of a rare condition might have improved this patient's
I suggest a much more valuable lesson is that GP home visits cause
inappropriate delay for patients with chest pain, breathlessness, frothy
pink sputum (and oxygen saturations of 80%).
Telephone triage of all visit requests, and appropriate use of a 999
ambulance would have delivered this patient, conscious and breathing, to
hospital, and allowed her to give her history direct to the Physicians,
who are better placed to recognise rare diagnoses than we humble GPs.
Our role is simply to identify those ill enough to need secondary
care, not to reliably identify the underlying cause.
Competing interests: No competing interests