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Massive pulmonary embolism — RCPSC EM MCQ

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HardCardiovascular emergenciesMassive pulmonary embolismRCPSC EM

A 39-year-old woman 8 days postpartum collapses in triage with pleuritic chest pain. Blood pressure is 78/44 mmHg, oxygen saturation 86% despite high-flow oxygen, ECG shows sinus tachycardia with right heart strain, and bedside echo shows a dilated hypokinetic right ventricle. What is the most likely diagnosis?

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Correct answer: B — Massive pulmonary embolism

Postpartum status, pleuritic pain, shock, hypoxaemia, right-heart strain, and RV dilatation indicate massive pulmonary embolism.

Reference: Thrombosis Canada VTE guidance; ACLS