Question

A 38-year-old very low-risk patient (no hemoptysis, no estrogen, HR 78/min, SaO2 99%, age <50, no unilateral leg swelling, no recent surgery/trauma, no prior VTE) presents with pleuritic chest pain. What is the next step?

Accepted Answer

Apply the PERC rule; no further testing if negative

Answer

Order CT pulmonary angiography

Answer

Order D-dimer testing

Answer

Start empiric anticoagulation

Answer

Admit for observation and serial enzymes

Practice question

A 38-year-old very low-risk patient (no hemoptysis, no estrogen, HR 78/min, SaO2 99%, age <50, no unilateral leg swelling, no recent surgery/trauma, no prior VTE) presents with pleuritic chest pain. What is the next step?