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Pulmonary embolism low-risk testing — ABEM Board MCQ

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ModeratePulmonary emergenciesPulmonary embolism low-risk testingABEM Board

A 28-year-old woman arrives with pleuritic chest pain after a long flight. Triage acuity is ESI 3; BP 124/78 mm Hg, HR 104/min, SpO2 98%. She takes estrogen-containing contraception and has no hemoptysis or leg swelling. ECG shows sinus tachycardia, and chest radiograph is normal. Which of the following is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Obtain a D-dimer assay if clinical probability is low to intermediate

In a stable low- or intermediate-risk patient who is not PERC negative, D-dimer is an appropriate next diagnostic step.

Reference: ACEP Acute Venous Thromboembolic Disease clinical policy