Lando, a 55-year-old architect, presents complaining of central chest pain, cough and dyspnoea.

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Dr Paul Muthiah is a GP on the Central Coast, NSW and medical co-editor at Australian Doctor.

Reprinted from The Permanente Journal, 15 (4), Levis JT, ECG Diagnosis: Pulmonary Embolism, https://doi.org/10.7812/TPP/11-112, copyright (2011), with permission from The Permanente Federation