A 57-year-old man with a history of COPD, atrial fibrillation, and diabetes presented to the ED complaining of chest pain and shortness of breath that started while he was sleeping that night. He uses BiPap (settings 24/20) for sleep apnea.
He is a former smoker, but denies any recent cough, fevers, lower extremity swelling, or worsening orthopnea. He is in mild respiratory distress sitting upright in bed with his heart rate 105 beats per minute, respiratory rate 27 breaths per minute, blood pressure 164/77 mm Hg, and 90% on room air. His chest x-ray is shown.
What is the diagnosis and treatment of this condition? See p. 14.