Question

A 45-year-old woman on the acute medical unit has chest pain and shortness of breath. Her Wells score for pulmonary embolism is calculated as 2.5 (PE unlikely). She has no haemodynamic instability. According to NICE VTE guidance, what is the next best investigation?

Accepted Answer

D-dimer testing; if negative, PE can be excluded without imaging.

Answer

Immediate CT pulmonary angiography for all suspected cases.

Answer

Ventilation–perfusion scan without D-dimer as Wells score is not high.

Answer

Lower limb venous ultrasound only.

Answer

Empirical therapeutic low molecular weight heparin without further tests.

Practice question

A 45-year-old woman on the acute medical unit has chest pain and shortness of breath. Her Wells score for pulmonary embolism is calculated as 2.5 (PE unlikely). She has no haemodynamic instability. According to NICE VTE guidance, what is the next best investigation?