A 32-year-old woman on oral contraceptives presents with acute dyspnea and pleuritic chest pain. Vital signs show HR 112 bpm, BP 128/82 mmHg, RR 22/min, SpO2 88% on room air, and temperature 37.2°C. Chest X-ray is normal. Arterial blood gas reveals pH 7.48, PaCO2 32 mmHg, and PaO2 58 mmHg. D-dimer is elevated at 2.1 μg/mL. No unilateral leg swelling is noted. Which diagnostic test is most appropriate next?
- A)Ventilation-perfusion scan
- B)Repeat chest X-ray in 6 hours
- C)Echocardiography
- D)Computed tomography pulmonary angiographyGABARITO
- E)Impedance plethysmography
Explicação
CTPA is the gold standard imaging modality for diagnosis of pulmonary embolism in patients with normal or nonspecific chest X-ray findings and high clinical suspicion. The clinical presentation (dyspnea, pleuritic pain, tachycardia, hypoxemia with hypocapnia, ... Ver explicação completa e trilha adaptativa →