Question

A 68-year-old woman presents with acute onset pleuritic chest pain and dyspnoea. Her Wells score for pulmonary embolism is low, and she has no signs of DVT. According to evidence-based diagnostic pathways used in Canada, what is the most appropriate next step?

Accepted Answer

Order a D-dimer test and if negative, exclude pulmonary embolism

Answer

Proceed directly to CT pulmonary angiography

Answer

Start therapeutic anticoagulation immediately without further testing

Answer

Order a ventilation-perfusion scan regardless of pretest probability

Answer

Admit for observation for 24 hours without testing or treatment

Practice question

A 68-year-old woman presents with acute onset pleuritic chest pain and dyspnoea. Her Wells score for pulmonary embolism is low, and she has no signs of DVT. According to evidence-based diagnostic pathways used in Canada, what is the most appropriate next step?