They can present in so many different ways, and are famous for their deception in presentation. This review from NEJM walks us through a nice little diagnostic pathway using some decision rules (remember the Wells and Geneva scores?), and then goes through the management.
The sudden onset shortness of breath with pleuritic chest pain in the older international airline pilot isn’t the difficult one; its the young lady who is a bit short of breath who you’re not sure about exposing to the radiation risk, and the scores can be handy in helping to stratify risk.
Of course, once you know the diagnosis you need to know how to treat it, and again, we’re treated to a nice little pathway. Burn the article and those images into your mind over here.
IMAGE: Pulmonary Pathology