A 38-year-old woman has presented to the emergency department with chest pain and shortness of breath. The pain is located around the right side of her chest and is made worse on deep inspiration. The shortness of breath had come on suddenly at rest. She denies any symptoms of cough or fever. Her history is significant for two miscarriages and a deep vein thrombosis (DVT) in her left calf. Apart from the oral contraceptive pill, she does not take any regular medications.
Her sister also had a DVT some years ago. Examination This woman’s chest has good air entry throughout all lung fields with no added sounds.Her calves are soft and non-tender and there is no pitting oedema. Her full blood count and renal function tests are unremarkable. A chest X-ray is normal. Observations: heart rate 94/min, blood pressure 126/82 mmHg, respiratory rate 20/min, SaO2 94 % on room air. What can be the…
