Working Diagnosis

My working diagnosis is pulmonary embolism.

  1. Sudden onset
  2. Female on birth control pills
  3. Consistent CXR
  4. Widened A-a gradient

My alternate consideration is viral or idiopathic pleurisy. The patient's family was ill with an upper respiratory infection one week ago. While other causes for pleurisy are certainly a consideration, the first order of business is to rule out pulmonary embolism.