A 29-year-old woman complained of a sudden onset of right-sided chest pain with shortness of breath. It woke her from sleep at 3.00 am. The pain was made worse by a deep breath and by coughing. The breathlessness persisted over the 4 h from its onset till now. She has a slight non-productive cough. There is no relevant previous medical history except asthma controlled on salbutamol and beclometasone. There is no family history of systemic diseases. Examination Her respiratory rate is 24/min, the jugular venous pressure is raised 3cm, the blood pressure is 110/64mmHg and the pulse rate 128/min. Peak flow rate is 410L/min. In the respiratory system, expansion is reduced because of pain. Percussion and tactile vocal fremitus are normal and equal. A pleural rub can be heard over the right lower zone posteriorly. There are no other added sounds. Otherwise the examination is normal.

(Edited)

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