Question

A 45-year-old woman with no prior thromboembolism presents with acute pleuritic chest pain and dyspnea. CT pulmonary angiography shows a segmental pulmonary embolus. She is hemodynamically stable with normal renal function and no cancer. Which is the most appropriate initial outpatient anticoagulation regimen?

Accepted Answer

Start a direct oral anticoagulant such as apixaban at full treatment dose without heparin lead-in.

Answer

Begin low-molecular-weight heparin and overlap with warfarin for at least 5 days until INR is therapeutic.

Answer

Start aspirin 325 mg daily as monotherapy.

Answer

Admit for unfractionated heparin infusion and defer oral therapy until discharge.

Answer

Inferior vena cava filter placement without anticoagulation.

Practice question