Rule Out / Past cases / Pulmonary embolism
Rule Out case #4 · ModeratePulmonary embolism: a six-clue practice case
Read the clues in order and name the diagnosis as early as you can. Clues move from the patient’s story to the classic findings.
Play it as a game firstGuess before each clue unlocks, then share your score.The clues
Clue 1: A 34-year-old woman suddenly becomes short of breath at work.
Clue 2: She flew home from Tokyo 3 days ago on a 13-hour flight.
Clue 3: Breathing in deeply causes a sharp pain on the right side of her chest.
Clue 4: Heart rate is 118 and oxygen saturation is 90% on room air, yet her lungs sound clear.
Clue 5: Her left calf is swollen and tender.
Clue 6: CT angiography shows a filling defect in the right pulmonary artery.
Show the diagnosis and takeaways
What gives it away
- Sudden shortness of breath, pleuritic chest pain and a fast heart rate with clear lungs should raise suspicion for PE.
- Risk factors include long travel or immobility, recent surgery, cancer, estrogen, pregnancy and prior clots.
- CT pulmonary angiography confirms it; anticoagulation is the mainstay of treatment.
Ran as Rule Out #4 (Wednesday, October 21, 2026).
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