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The Chest X-Ray (Figure 1) shows right unilateral pulmonary oedema with small bilateral pleural effusions. Unilateral pulmonary oedema can easily be mistaken for other pathologies such as pneumonia

The portable chest x-ray (Figure 1) shows a widened cardiac silhouette. An endotracheal tube is in situ, indicating the patient is now intubated.

The ECG (Figure 2) shows sinus rhythm with widespread

The initial ECG (figure 1A) demonstrates a regularly irregular rhythm at approximately 80bpm. There is a profound first-degree atrioventricular(AV) block with a PR interval of over 400ms. There is


Severe headaches are a frequent presentation to the Emergency Department, accounting for around 1% of presentations. Of these, 13-16% will have a sinister underlying pathology