Question

A 65-year-old man presents with a 2-day history of pleuritic chest pain and breathlessness. He has a recent history of total hip replacement 3 weeks ago. Heart rate is 110 bpm, respiratory rate 26 breaths/min, oxygen saturation 92% on air, blood pressure 118/74 mmHg. His Wells score for pulmonary embolism is 6 (PE likely). What is the most appropriate next step in management?

Accepted Answer

Start treatment-dose low molecular weight Heparin and arrange an urgent CT pulmonary angiogram

Answer

Arrange a D-dimer test and await the result before treating

Answer

Discharge with safety-netting and organise an outpatient CT pulmonary angiogram

Answer

Request a ventilation–perfusion scan without anticoagulation

Answer

Give Aspirin and arrange a routine respiratory clinic appointment

Practice question