Intended for healthcare professionals

Rapid response to:

Practice Interactive case report

A 28 year old postpartum woman with right sided chest discomfort: case presentation

BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7538.406 (Published 16 February 2006) Cite this as: BMJ 2006;332:406

Rapid Response:

First I think of pneumothorax

The first possible diagnosis I consider is pneumothorax because: -

Right sided chest pain increased by activity, - Cardiac electrical
rotation on the longitudinal axis.

I'd like to have a chest x-ray to confirm or exclude pneumothorax. If
chest x-ray is normal I'll consider pulmonary embolism and I'd like to
have an ELISA D-dimer. If D-dimer is increased it's necessary to have a
pulmonary V/Q scan. If V/Q scan is normal it's necessary to confirm or
exclude great vessels, parietal or mediastinal pathologies with a chest
CT.

Competing interests:
None declared

Competing interests: No competing interests

20 February 2006
Cleante Scarduelli
Medical Doctor Cardiopulmonary Rehabilitation
Presidio riabilitativo multifunzionale di Bozzolo via XXV Aprile 46012 Bozzolo Italy