A 30-year-old woman, three days postpartum, suddenly has difficulty breathing and decreased level of consciousness. What should you suspect?

In this scenario, the sudden onset of difficulty breathing and a decreased level of consciousness in a woman who is three days postpartum raises a strong suspicion for pulmonary embolism. During the postpartum period, women are at an increased risk of developing blood clots, especially if they have other risk factors such as prolonged immobility or a history of clotting disorders. A pulmonary embolism occurs when a blood clot lodges in the pulmonary arteries, obstructing blood flow to the lungs, which can lead to significant respiratory distress and decreased oxygenation, resulting in hypoxia and altered mental status.

The clinical presentation of sudden onset dyspnea (difficulty breathing) and decreased consciousness in this context aligns well with pulmonary embolism. It is a critical condition that requires immediate medical attention, as it can lead to severe complications or even death if not treated promptly.

In contrast, other conditions listed, while they can also cause respiratory symptoms, do not fit as perfectly with the patient's postpartum status and acute presentation. For example, intrauterine bleeding would not typically present with respiratory distress unless there was significant hemodynamic instability, which is less likely given the symptoms described.

Spontaneous pneumothorax may lead to sudden chest pain and difficulty breathing, but it