Undifferentiated SOB

A 31yo male presented to the ED with shortness of breath, presyncope and left sided pleuritic chest pain for 3 days. 

4/52 ago he had a lap cholecystectomy with a 5 day hospital stay. He reported a cough, night sweats and malaise. No abdominal pain or bowel Sx. Abdomen was soft and NT. Chest was clear except for L basal crackles. Calves were soft and NT. 

Obs HR 110 ST, sats 93% on RA, BP 130/65, temp 38.5

ECG showed a ST, no acute ST changes.

While awaiting CXR and bloods, the registrar and I performed a bedside lung and cardiac ultrasound. 

These are the relevant lung US findings:

This is R1. Similar finidings were seen in L1-2 and R2

We then proceeded to ultrasound his heart given the presyncope. 

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