Pulmonary Embolism 20
A 45-year-old female presents to the emergency department with sudden onset of sharp chest pain and shortness of breath. The pain worsens with deep breathing, and she describes it as a stabbing sensation on the right side of her chest. She also reports feeling lightheaded and notes that her heart has been racing. The symptoms started about two hours ago while she was sitting at her desk at work.
Her medical history includes obesity and a recent knee surgery two weeks ago, from which she has been recovering. She has been relatively immobile during her recovery and has not been using compression stockings or blood thinners. She denies any recent illnesses, fever, or cough.
On examination, her blood pressure is 100/70 mmHg, heart rate is 115 beats per minute, respiratory rate is 24 breaths per minute, and oxygen saturation is 92% on room air. She is mildly diaphoretic and anxious. Her lungs are clear to auscultation, but she has mild right-sided chest tenderness. The rest of her physical exam is unremarkable.
A CT pulmonary angiogram confirms the presence of a large pulmonary embolism (PE) in the right pulmonary artery. She is started on anticoagulation therapy with low molecular weight heparin and transitioned to oral anticoagulants for long-term management. The patient is monitored closely for signs of hemodynamic instability and is counselled on the importance of early mobilization and the use of anticoagulation following surgery to prevent further thromboembolic events.
A) Myocardial infarction
B) Pulmonary embolism (PE)
C) Pneumonia
D) Aortic dissection
A) Obesity and recent knee surgery with immobility
B) Family history of heart disease
C) Smoking
D) Use of oral contraceptives
A) Antiplatelet therapy
B) High-dose steroids
C) Anticoagulation therapy with heparin
D) Oxygen therapy alone
A) Productive cough and fever
B) Stabbing chest pain, shortness of breath, and tachycardia
C) Sudden onset of headache and blurred vision
D) Haemoptysis and wheezing
