Question

A 72-year-old woman develops sudden onset pleuritic chest pain and shortness of breath 5 days after a hemiarthroplasty. She is hypotensive at 80/50 mmHg, tachycardic at 130 bpm and oxygen saturation is 84% on 15 L oxygen. ECG shows sinus tachycardia. What is the most appropriate immediate management?

Accepted Answer

Administer thrombolysis with intravenous Alteplase.

Answer

Arrange urgent CT pulmonary angiography to confirm pulmonary embolism.

Answer

Start low molecular weight heparin at treatment dose and arrange Doppler ultrasound of the legs.

Answer

Give a fluid bolus and observe for 1 hour before further treatment.

Answer

Arrange a V/Q scan for the next available slot.

Practice question