We report a case of a young man who had a new onset S wave in lead 1 in his ECG with typical symptoms of acute onset of dyspoena 2 months after an episode of deep vein thrombosis, S wave disappeared 6 days after thrombolysis. We report this case as the clinical course was very typical plus we have reviewed the literature regarding diagnosis and risk stratification of pulmonary embolism for the student, or the casualty medical officer.