• Syril, a patient of 67 years of age trains under your supervision. He has 40 pack years of smoking history.
• Four months ago he received a total hip arthroplasty (right side). This operation was complicated by a deep venous trombosis. After discharge from the hospital rehabilitation was further uncomplicated. The patient trains with you as he wants to lose weight.

What tests do you want to have prior to start working with this patient?

• During his cycling exercise the patient complaints of chest pain he stops exercise and he is clearly hyperventilating.
• His transcutaneous oxygen saturation is 89%

What potential diagnosis do you think of?
What do you do?

Pulmonary Embolism

• Rate of onset
  • Seconds - 41%
  • Minutes - 26%
  • Hours - 20%
  • Days - 19%
• Clinical features
  • Tachypnoea  >20/min 57%
  • Tachycardia >100/min 26%
  • DVT signs calf and/or thigh 61%

What do you do?

• Medical emergency
• Stop exercise
• Measure StcO2, HR
• Provide O2 if possible