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Pulmonary embolism diagnosis — SCE Respiratory MCQ

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ModeratePulmonary Vascular DiseasePulmonary embolism diagnosisSCE Respiratory

A 54-year-old woman presents with pleuritic chest pain and dyspnoea 10 days after knee replacement. Wells score indicates PE likely. eGFR is 76 mL/min/1.73 m2 and CXR is normal. What is the most appropriate investigation?

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Correct answer: D — CT pulmonary angiography

When PE is likely by Wells score, definitive imaging is required without relying on D-dimer; CTPA is first-line when renal function is adequate. A V/Q scan is useful when CTPA is contraindicated or to reduce radiation in selected patients. Echocardiography alone does not exclude PE in a stable patient.

Reference: NICE NG158