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Postpartum pulmonary embolism — RCPSC EM MCQ

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HardCardiovascular emergenciesPostpartum pulmonary embolismRCPSC EM

A 32-year-old woman has pleuritic chest pain and dyspnoea three weeks after a caesarean birth. Heart rate is 118/min and oxygen saturation is 94%. She is haemodynamically stable and has no contrast allergy. D-dimer is elevated. What is the most appropriate initial management?

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Correct answer: A — CT pulmonary angiography with pregnancy/postpartum-informed radiation discussion

Postpartum status increases venous thromboembolism risk. In a stable patient with suspected PE, CTPA or V/Q scanning is selected based on chest radiograph, local availability and shared radiation discussion.

Reference: Thrombosis Canada pregnancy-associated VTE guidance; Canadian Association of Radiologists