A normotensive patient with PE has RV dilation, positive troponin, HR 118/min and lactate 2.4 mmol/L but no deterioration after initial

Question

A normotensive patient with PE has RV dilation, positive troponin, HR 118/min and lactate 2.4 mmol/L but no deterioration after initial anticoagulation. What is the current treatment strategy?

Accepted Answer

Continue therapeutic anticoagulation with monitored admission and a rescue-reperfusion contingency plan

Answer

Withhold anticoagulation while a pulmonary embolism response team chooses a catheter procedure

Answer

Insert an IVC filter and stop anticoagulation because lactate exceeds 2 mmol/L

Answer

Give routine systemic thrombolysis immediately because RV dilation and troponin define massive PE

Answer

Discharge on a DOAC because normal systolic pressure excludes early deterioration

Calcium-channel blocker poisoning — RCPSC EM MCQ

A normotensive patient with PE has RV dilation, positive troponin, HR 118/min and lactate 2.4 mmol/L but no deterioration after initial anticoagulation. What is the current treatment strategy?