A 69 year-old-woman is brought to the emergency department by her husband 46 minutes after she had sudden onset of dyspnea and severe pain the left side of the chest. The patient underwent right total hip replacement three weeks ago. Temperature is 37,3C pulse rate is 120/min, respiration rate are 22/min and labored, and blood pressure is 140/88mmHg in the left arm with the patient supine. The patient seems anxious. Physical examination shows persistent cough. Auscultation of the chest shows accentuation of the pulmonary component of S2, unilateral crackles, and wheezing. Which of the following is the most likely diagnosis?
a) acute MI
b) aortic aneurysm
c) bacterial pneumonia
d) pulmonary embolism
