In anticipation of episode 21 on respiratory emergencies, I have with us Dr. John Foote, who's going to tell us about his best case ever when it comes to a patient who presents to the emergency apartment with dysmia.

The case that I'm going to present is maybe not as dramatic as some of the other cases that have presented on the best cases ever,

but this is certainly my most memorable respiratory case.

I was working in our department in the RAS area, which is for the less acutely ill-appearing patients.

I was asked to see a 44-year-old professor from a local university who'd come in complaining of increasing exertional shortness of breath over the ensuing three weeks.

Now, he was triaged to this less acute area of the emergency department because triage vital signs were very unremarkable.

The saturation on Romare was 97% Respiratory rate, I'm not sure

if it was actually measured at the triage. It was 20, and I did look, and I would confess that I didn't

measure it myself, but it did not appear to be elevated. His heart rate, his pulse was 54 and regular,

and his blood pressure was in the normal range.

I was on no medications.

He was a non-smoker.

He did not look pale.

And he was, came in, he walked in with his laptop and all of his research, looking very

comfortable.

And I think the feeling of the people I was working with and the nurses in the area where

that this guy is just anxious about his research

and that there's nothing terribly wrong and I went in a bit with that bias myself. Prior to me

seeing him, the nurses hadn't done blood work, but they did do an ECG. The ECG showed sinus rhythm

with as again, and the heart rate was in the 50s. And the only abnormality I could see,

which I initially thought they were just nonspecific T-wave changes.

If you look a bit more closely,

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