A 44-year-old man was admitted to the emergency service because of an acute onset of dyspnoea and unspecific abdominal pain during the previous 4days. His medical history was unremarkable. He was in sinus tachycardia, with fever and hypoxemia. Chest X-ray and blood tests were normal except from discrete hyperbilirubinemia. While he was in the emergency unit, he suffered acute respiratory and hemodynamical failure and he was admitted to the intensive care unit. The patient suffered a first episode of cardiac arrest and transesophageal echocardiography was performed.
