A 55-year-old male with a history of hypertension and smoking presents with sudden onset shortness of breath and sharp, pleuritic chest pain. His blood pressure is 145/95 mmHg. What could be the potential causes, and what are the next steps?
Given his risk factors, this patient's symptoms could be suggestive of a pulmonary embolism. Other potential diagnoses include pneumothorax, pneumonia, or acute coronary syndrome. Immediate evaluation should include an EKG, chest X-ray, D-dimer test, and potentially a CT pulmonary angiography if PE is strongly suspected. The blood pressure is elevated but not dangerously so, and managing his acute symptoms should be the priority.