In this clinical case, Alex Romain is taken through the examination of a patient after GP referral for shortness of breath and tiredness by Sandeep Ghandi, from the Medway Maritime Hospital in Kent.

The case is split into 3 sections, examination, history and treatment.

To help with your diagnosis we’ve provided an ECG http://bit.ly/159GNRL, an x-ray http://bit.ly/11XDsPK, and a spreadsheet of blood-test results http://bit.ly/YmAyqT.