A 70-year-old woman with acute right ventricular failure and circulatory collapse.

70-year-old woman with osteoarthritis and a remote history of diverticulitis presented to her primary-care physician with intermittent fevers and dyspnea. These symptoms began 1 day after a recent visit to her family where she reported exposure to grandchildren who were sick with an upper respiratory infection. She was given a diagnosis of a viral infection and advised to take conservative measures. Two days later, the patient presented to the ED with persistent high-grade fevers, diffuse aches, and worsening dyspnea. Physical Examination On presentation, the patient’s vital signs were normal except for tachypnea, with a respiratory rate of 26 breaths/min. Pulse oximetry showed 100% saturation while breathing ambient air. General examination results were normal. Chest auscultation revealed bilateral coarse lung sounds with diffuse rhonchi. Cardiac auscultation revealed normal heart sounds with no murmurs, rubs, or gallops. The abdomen was soft, nontender, and nondistended without organomegaly.