A 67-year-old female presents with sudden chest pain that began 10 minutes ago. She is on antibiotics for an infection from hip surgery last week. Vital signs show elevated blood pressure. What should you suspect?

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Sudden chest pain in a patient recently immobilized by hip surgery points strongly toward a pulmonary embolism. After surgery, legs are prone to deep vein thrombosis because of stasis and inflammation, and a clot can travel to the lungs, causing abrupt chest pain and possible shortness of breath. The body's response to the embolus can keep blood pressure up initially, though it can drop if the PE is large. This fits better than the other options: a heart attack tends to feel more like pressure or squeezing with potential radiation and sweating; a pneumothorax usually presents with unilateral breath sounds affected and hyperresonance; an aortic dissection causes a sudden, severe tearing pain often radiating to the back. Therefore, pulmonary embolism is the most likely diagnosis in this scenario.