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Download the article PDF: Clinical Image Challenges October 2026
A 62-year-old female presents to urgent care with acute dyspnea that worsened significantly 2 hours prior to arrival. She has noted progressive shortness of breath over the past week but now feels severely winded. She denies chest pain, cough, fever, leg swelling, or history of deep vein thrombosis.
On evaluation, the patient is tachycardic and tachypneic with a heart rate of 110 beats per minute and an oxygen saturation of 91% on room air. She is alert and speaking in short sentences. An electrocardiogram (ECG) is obtained.
View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Case presented by Jonathan Giordano, DO, MEd, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center.
62-Year-Old With Acute Dyspnea
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