"Nothing's gonna change my world": Why?

Physical examination can be a guide to diagnosis when we know what is to be searched for [1]. In the approach to dyspnoea, postural changes are usually considered only to distinguish whether the symptoms worsen (i.e. heart failure), or are unaffected by the supine position (i.e. laryngeal oedema, bronchial asthma, pneumonia.) This simple approach does not cover a third possibility: that is the improvement of the symptoms (dyspnoea) in the supine position, and in our patient, [2] the correct diagnosis was initially missed. At admission, attention was attracted to the blood gas-analysis: hypoxia with hypocapnia leading to the clinical suspicion of a pulmonary embolism.