Question

A 32-year-old pregnant woman at 26 weeks gestation presents with sudden onset pleuritic chest pain and shortness of breath. She is tachycardic, mildly hypoxic and has a normal chest X-ray. You suspect pulmonary embolism (PE). According to NICE and pregnancy guidelines, what is the most appropriate initial imaging investigation?

Accepted Answer

Ventilation–perfusion (V/Q) scan if chest X-ray is normal

Answer

CT pulmonary angiography (CTPA) as first-line in all pregnant women

Answer

D-dimer test and, if positive, no further imaging

Answer

No imaging and start anticoagulation empirically without confirmation

Answer

Pulmonary angiography via catheter

Practice question