Question

On April 17, a 33 y/o female CPA started to notice some vague calf pains associated with increasing swelling of her legs. Unperturbed, she continued her usual activities although her leg pains seemed to worsen when she was up walking around. She decided to continue to walk her normal 3 mile route since the doctor had warned her of the effects of menopause on bone density and recommended that she walk to increase her bone mass while she could. On her walk, she noticed that she was a bit short of breath if she tried to walk fast, so she slowed down and tried to pace herself. She thought that maybe she was just out of shape after the winter. About 25 minutes into her walk, her ribs began to ache on the right side and she became very short of breath. A concerned passerby stopped to see if she was alright when she fell unconscious to the ground.  

What would you do next to support your diagnosis based on these observations, what would your initial diagnosis be?

How would you treat this Px?

What further tests would you run to support your diagnosis.

Answer 1

• The condition can be diagnosed as pulmonary embolism due to DVT( deepvein thrombosis).Deep vein thrombosis is a condition caused due to presence of blood clots in the deep veins of the body especially the legs.The clot can dislodge and get ino the lungs and cause pulmonary embolism causing shortness of breath and chest pain.
• The immediate treatment is the use of thrombolytic drugs along with the resusication of the patient by stabilising the patients vitals.As a long term measure we can administer blood thinner drugs and thrombolytic drugs.
• Diagnostic tests includes electrocardiogram, chest x-ray, echocardiogram, and CT pulmonary angiography. For confirming or excluding PE: D-dimers, biomarkers of myocardial injury and overload, blood gases, clotting tests, and ventilation-perfusion scans are also performed.