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Massive pulmonary embolism — RCPSC EM MCQ

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HardRespiratory emergenciesMassive pulmonary embolismRCPSC EM

A 59-year-old with cancer presents with pleuritic chest pain, syncope and severe dyspnoea. BP 78/48, HR 142, SpO2 86%, bedside echo shows RV dilatation, and ECG shows sinus tachycardia. What is the most likely diagnosis?

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Correct answer: A — Massive pulmonary embolism

Shock with hypoxaemia and acute RV strain in a high-risk patient strongly suggests massive pulmonary embolism.

Reference: Canadian venous thromboembolism guidance; emergency ultrasound practice