Question

A 59-year-old woman with no significant past medical history presents with pleuritic chest pain and dyspnoea 2 days after knee replacement surgery. She is tachycardic and mildly hypoxic. Her two-level Wells score for pulmonary embolism (PE) is high. According to NICE NG158, which is the most appropriate immediate management?

Accepted Answer

Start therapeutic anticoagulation and arrange a CT pulmonary angiogram within 4 hours if possible

Answer

Arrange a CT pulmonary angiogram within 24 hours and discharge home meanwhile

Answer

Wait for a D-dimer result before starting anticoagulation

Answer

Give prophylactic-dose low-molecular-weight heparin and arrange outpatient CT

Answer

Admit for observation without anticoagulation until imaging is available

Practice question