The combination of sudden shortness of breath and pleuritic chest pain after surgery most likely indicates?

• A. Pneumothorax
• B. Myocardial infarction
• C. Pulmonary embolism
• D. Pulmonary edema

Answer: (C)

Pulsing through here is the idea that this combination after surgery points to a pulmonary embolism. When someone has just had surgery, the risk of venous clots forming in the legs or pelvis rises because of immobility, inflammation, and a tendency for the blood to clot. If a clot breaks loose, it can travel to the lungs and block a pulmonary artery. That sudden blockage disrupts blood flow to part of the lung, causing an abrupt drop in oxygen levels and a sharp, pleuritic chest pain—pain that worsens with deep breaths. The chest pain comes from irritation of the pleura around the lungs as the embolus lodges and possible small infarctions occur.

This scenario fits PE best because of the sudden shortness of breath combine with pleuritic chest pain in the immediately postoperative setting, where PE is a leading concern. While other conditions can cause similar symptoms, the postoperative context and the character of the chest pain point most toward a pulmonary embolism rather than a heart attack, pulmonary edema, or a pneumothorax, which have different typical patterns (for example, MI pain is often pressure-like and not strongly pleuritic; pulmonary edema brings orthopnea and crackles; pneumothorax could also cause pleuritic pain but is less specifically tied to the postoperative context).