A woman with a high probability of pulmonary embolism by the Wells score has a CT pulmonary angiogram delayed by several hours. What is the correct interim management?
Answer and explanation
Correct answer: D. Start a direct oral anticoagulant or low molecular weight heparin while awaiting imaging
- Step 1: A likely PE carries a high early mortality if untreated. Step 2. NICE advises interim therapeutic anticoagulation when imaging cannot be done at once, in the absence of contraindications. Answer: Start a direct oral anticoagulant or low molecular weight heparin while awaiting imaging. Why not the others: Waiting leaves a probable embolus untreated. Aspirin is not adequate therapy. Thrombolysis is reserved for haemodynamically unstable massive PE.
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