Question

A 63-year-old man presents with new-onset dyspnoea and pleuritic chest pain. CT pulmonary angiography confirms bilateral pulmonary emboli. He is haemodynamically stable, has normal renal function, and no active cancer. According to Thrombosis Canada guidance, what is the most appropriate initial anticoagulation strategy?

Accepted Answer

Begin a direct oral anticoagulant at therapeutic dose without heparin lead-in where indicated

Answer

Intravenous unfractionated heparin targeting an aPTT of 2-3 times control, then bridge to warfarin

Answer

Low-molecular-weight heparin for 5 days followed by warfarin with an INR target of 1.5-2.0

Answer

Inferior vena cava filter alone with no anticoagulation

Answer

Aspirin 81 mg daily as monotherapy

Practice question