A 34-year-old woman presents with sudden-onset pleuritic chest pain and dyspnoea. She uses oestrogen-containing contraception and returned from a long...

Question

A 34-year-old woman presents with sudden-onset pleuritic chest pain and dyspnoea. She uses oestrogen-containing contraception and returned from a long-haul flight 3 days ago. Vitals: BP 118/72 mm Hg, HR 104, RR 22, SpO₂ 96% on room air. Her Wells score is low. According to evidence-based PE diagnostic algorithms, what is the best next step?

Accepted Answer

Order a D-dimer test

Answer

Proceed directly to CT pulmonary angiography

Answer

Start full-dose anticoagulation immediately without further testing

Answer

Order a ventilation-perfusion (V/Q) scan without D-dimer

Answer

No further testing is needed due to normal oxygen saturation

ca-mccqe1 MCQ (SBA): Pulmonary embolism diagnostic approach