Advanced Medical Life Support (AMLS)

In this scenario, considering the patient's sharp chest pain that intensifies when lying supine and their recent hip surgery, a pulmonary embolism (PE) is the most likely diagnosis. Pulmonary embolism often arises in individuals who have undergone recent surgeries, particularly orthopedic procedures, due to the increased risk of deep vein thrombosis (DVT). A DVT can break free, travel to the pulmonary circulation, and cause a blockage in the arteries of the lung, leading to symptoms such as sharp chest pain, shortness of breath, and sometimes hemoptysis. The pain worsening when supine may indicate that the embolism is influencing the positioning of the lungs or heart, potentially causing more strain or discomfort when lying flat. Moreover, sharp chest pain is a characteristic symptom of PE, as opposed to other conditions that may present with different types of pain or additional symptoms. Understanding these connections between the patient's history, symptoms, and potential complications is crucial in emergency medical settings and ultimately supports the reasoning for identifying a pulmonary embolism in this case as the most fitting diagnosis.