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Pulmonary embolism with low-risk features — RCPSC EM MCQ

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HardRespiratory emergenciesPulmonary embolism with low-risk featuresRCPSC EM

A patient with acute PE is PESI class I and needs no oxygen or parenteral analgesia, but CT shows right-ventricular dilation and troponin is elevated. Follow-up and home support are reliable. What is the best disposition?

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

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Correct answer: C — Admit for monitored treatment given the higher-risk prognostic markers

Explanation lettering: B = shown as A · C = shown as B · D = shown as C · A = shown as D

D is correct: low PESI identifies low clinical risk, but RV dilation and myocardial injury are higher-mortality markers that warrant caution and monitored treatment. E, A and B overrule prognostic discordance. C postpones both disposition and necessary anticoagulation.

Reference: Thrombosis Canada, Pulmonary Embolism—Treatment: https://thrombosiscanada.ca/hcp/practice/clinical_guides?guideID=44&language=en-ca