A 58-year-old woman presents to the emergency department with sudden onset dyspnea and pleuritic chest pain 5 days after total knee replacement surgery. Her heart rate is 112 bpm, blood pressure is 130/85 mmHg, respiratory rate is 24, and oxygen saturation is 91% on room air. CT pulmonary angiography reveals a filling defect in the right main pulmonary artery with right ventricular dilation. Which of the following is the most appropriate initial management?
- A)Surgical embolectomy
- B)Inferior vena cava filter placement
- C)Systemic thrombolysis with alteplase
- D)Unfractionated heparin infusionGABARITO
- E)Oral rivaroxaban alone
Explicação
This patient has a submassive pulmonary embolism (PE with right ventricular strain but hemodynamic stability). Initial management is anticoagulation with unfractionated heparin. Systemic thrombolysis is reserved for massive PE with hemodynamic instability. USM... Ver explicação completa e trilha adaptativa →