A haemodynamically stable 67-year-old has pleuritic pain, haemoptysis and a two-level PE Wells score of 6.5. Renal function permits contrast, but scan...

Question

A haemodynamically stable 67-year-old has pleuritic pain, haemoptysis and a two-level PE Wells score of 6.5. Renal function permits contrast, but scanner failure means CTPA cannot be performed for six hours. There is no active bleeding. What should happen next?

Accepted Answer

Begin interim therapeutic anticoagulation and obtain CTPA when available

Answer

Obtain a quantitative D-dimer and anticoagulate only if it is positive

Answer

Request leg ultrasonography and anticoagulate only if proximal DVT is found

Answer

Perform transthoracic echocardiography and anticoagulate only if RV strain is found

Answer

Arrange ventilation–perfusion imaging after withholding anticoagulation for six hours

Pulmonary Embolism — MRCP Part 1 MCQ

A haemodynamically stable 67-year-old has pleuritic pain, haemoptysis and a two-level PE Wells score of 6.5. Renal function permits contrast, but scanner failure means CTPA cannot be performed for six hours. There is no active bleeding. What should happen next?