A young breathless patient.

A 34-year-old gentleman, with a background of osteoarthritis, presented to the Acute Medical Unit with a short history of breathlessness. He had returned from holiday to the United States five days previously. Since return, he had complained of myalgia, sore throat, a non-productive cough, mild anorexia and fevers at home. More acutely, prompting his presentation to hospital, was acute dyspnoea, which was sudden onset, with some central anterior chest discomfort and worse lying flat.