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Chronic thromboembolic disease — RCPSC IM MCQ

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ModerateRespirologyChronic thromboembolic diseaseRCPSC IM

A 59-year-old man has progressive dyspnoea 3 months after an unprovoked pulmonary embolism treated with apixaban. Oxygen saturation falls on exertion. Echocardiography shows right ventricular dilation and estimated pulmonary artery systolic pressure 58 mm Hg. CT pulmonary angiography is inconclusive. What is the most appropriate investigation?

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Correct answer: D — Ventilation-perfusion scan

Persistent dyspnoea and pulmonary hypertension after PE raise concern for chronic thromboembolic disease. V/Q scanning remains a sensitive screening test.

Reference: Canadian pulmonary hypertension practice guidance