A 71-year-old man presents with three days of dyspnoea. CT pulmonary angiography shows bilateral pulmonary emboli and right ventricular enlargement; his blood pressure is 128/76 mmHg, and he has no syncope or shock. His troponin concentration is raised, and his estimated glomerular filtration rate is 22 mL/min/1.73 m² (reference range greater than 60). Which one of the following is the most appropriate initial treatment?
Keep going — a set of ten like this one, one at a time.
Practise moreMore from Cardiovascular
See allA 76-year-old man reports that for three months he has felt light-headed and has twice nearly fainted walking up the hill to the shops, together with a tight fe…
Pre-internship · common
A 34-year-old man who injects heroin presents with two weeks of fevers, sweats, a cough and pleuritic chest pain on both sides. His temperature is 39.2 °C, puls…
Clinical rotations · middle twist
A 52-year-old Aboriginal woman from a community in Cape York presents with a week of palpitations and breathlessness on walking to the store. She had several ep…
Pre-internship · middle twist
A 68-year-old man is brought in by his wife after his third collapse in a month. Each time he has been sitting watching television, has suddenly gone grey and s…
Clinical rotations · middle twist
A 79-year-old woman is admitted with ongoing lower gastrointestinal bleeding and a haemoglobin concentration of 72 g/L (reference range 115–155). She is receivi…
Pre-internship · middle twist