A 22-year-old man presents to the emergency department complaining of a sudden onset of right-sided chest pain and shortness of breath. The symptoms began approximately 2 hours ago while he was watching television. He describes the pain as sharp, stabbing, and exacerbated by deep inspiration. He denies any recent trauma, fever, chills, cough, or hemoptysis. His past medical history is unremarkable, and he takes no regular medications. He has no known allergies. He has smoked half a pack of cigarettes daily for the past 4 years. He denies using illicit drugs, including marijuana. He is a college student and lives in a dormitory.

On general appearance, he is a tall, thin young man who appears mildly anxious but is in no acute respiratory distress. He is afebrile. His blood pressure is 118/76 mmHg with a heart rate of 105 bpm. His respiratory rate is 22 breaths per minute, and his oxygen saturation is 97% on room air.