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### What you need to know A 71 year old woman with hypertension, coronary artery disease, and heart failure presents to her GP with fatigue and breathlessness at rest over the past 10 days. She reports a mild non-productive cough and occasional sore throat during this time, and says that deep breaths make her chest feel “heavy.” She has had no fever, chest pain, abdominal pain, leg pain, or other abnormal symptoms apart from a brief episode of near syncope a few days ago that resolved without intervention. Her heart rate is 96 beats/min, blood pressure 148/78, respiratory rate 22 breaths/min, and she has an oxygen saturation level of 92% on room air; she is afebrile. On examination, she has mild tachypnoea but no jugular venous distension, no cardiac murmur, and normal lung sounds. She has trace swelling of both lower legs and normal distal pulses. An electrocardiogram (ECG) shows sinus rhythm without evidence of ischaemia. Point-of-care tests for covid-19 and influenza are both

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