A 65-year-old male is postoperative day 7 after right total knee arthroplasty. History includes controlled hypertension, type 2 diabetes, and hyperlipidemia managed with prescribed outpatient medications and a 30 pack-year smoking history reported during intake. Prescribed prophylactic enoxaparin was interrupted 2 days ago when the medication supply ran out. Family brought him to the ED for sudden sharp right-sided chest pain that worsens with inspiration and shortness of breath. Assessment shows BP 92/58, HR 124, RR 28, and SpO2 88 percent on room air, temperature 36.7 C with no recent fever or chills, and diaphoresis with anxiety while accompanied by family. He denies prior cardiac symptoms before this event. The right calf is mildly tender without visible swelling.
一位 65 歲男性為右側全膝關節置換術後第 7 天。病史包括控制良好的高血壓、第 2 型糖尿病及高脂血症，以處方門診藥物治療，以及入院時自述 30 包年吸菸史。處方預防性 enoxaparin 於 2 天前因藥物用完而中斷。家屬帶他至急診，主訴突發性右側尖銳胸痛，吸氣時加劇，伴呼吸短促。評估顯示血壓 92/58、心率 124、呼吸 28 次/分、室內空氣下 SpO2 88%，體溫 36.7°C，近期無發燒或寒顫，以及家屬陪伴下盜汗且焦慮。他否認此次事件前有心臟症狀。右小腿輕微壓痛，無可見腫脹。