Question

A 40-year-old man presents with sudden onset pleuritic chest pain and dyspnoea. He has recently had knee arthroscopy and has been relatively immobile. His Wells score for pulmonary embolism (PE) is high. According to contemporary PE diagnostic strategy, what is the most appropriate next step?

Accepted Answer

Arrange urgent CT pulmonary angiography

Answer

Order a D-dimer test and, if negative, exclude PE

Answer

Start direct oral anticoagulant therapy without imaging

Answer

Request a ventilation-perfusion scan as first-line test in all patients

Answer

Order lower-limb venous ultrasound only

Practice question

A 40-year-old man presents with sudden onset pleuritic chest pain and dyspnoea. He has recently had knee arthroscopy and has been relatively immobile. His Wells score for pulmonary embolism (PE) is high. According to contemporary PE diagnostic strategy, what is the most appropriate next step?