This 49-year-old gentleman suffering since 3 days ago with shortness of breath on exertion. This was causing him to rest after walking 10 - 15 meters, having previously had no problems with exercise. He had no chest pain or cough. He had taken a flight back to Miami from Italy two weeks ago. The man is overweight at 130kg and measures 180cm in height. He was admitted to Hospital with probable diagnosis of PE On admission: He is quite uptight and is tachypnoeic and sweating. His JVP was not seen. He had no evidence of calf tenderness or swelling. He has evidence of peripheral cyanosis