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The patient is a 16-year-old male who presents with difficulty breathing, pain in his throat, difficulty swallowing, and pleuritic chest pain. He reports that the symptoms began “a couple of hours” earlier. There is no history of trauma, choking, or recent dental procedure.

The patient looks well, and is quiet and not toxic. Pulse is 75, O2sat 94; there is no fever. Chest is normal, with bilateral air entry. Assessment is hindered by the patient’s inability to take deep breaths, however.

View the image and consider what your diagnosis and next steps would be.

16-year-old male experiencing chest and throat pain

Nahum Kovalski, BSc, MDCM

Clinical Researcher at TEREM Emergency Services
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