CASE 001 · Emergency Department · Intermediate · 8–12 min
The Patient Who Can't Breathe
· Patient arriving
67-year-old male — “My breathing has gotten much worse since yesterday.”
Walks in slowly at 6:40 AM, pausing every few steps. Refuses to lie back on the stretcher.
BP 184/112HR 118RR 30SpO₂ 88% RATemp 98.3°F
You do not get the diagnosis. You get the patient. Reason your way there.
What SHOULD be happening?A — Assess Normal
Left ventricle ejects blood effectivelyAdequate forward perfusionNormal filling pressuresNo pulmonary congestionEffortless breathing at rest
Somewhere in this chain, this patient's physiology has failed. Your job: find where — and how far back it started.
MaldekChin cases are for healthcare education and clinical-reasoning training. They do not replace local protocols, faculty instruction, clinical supervision, or professional judgment.