Q3: A 68-year-old man who underwent a left knee replacement 5 | FreeMedSite

Q3:

A 68-year-old man who underwent a left knee replacement 5 days ago comes to the emergency department with sudden onset right chest pain and shortness of breath. His temperature is 37.0°C (98.6°F), pulse is 110/min, respirations are 30/min,
and blood pressure is 134/82 mm Hg. After receiving supplemental oxygen, the patient's oxygen saturation is 96%, and the patient still feels short of breath. Lungs are clear to auscultation bilaterally and the
patient denies having a cough, producing sputum, or having nasal discharge. The cardiac examination is notable for tachycardia only. The surgical incision site
on the left knee is healing normally and reveals no sign of infection, but the left calf is somewhat edematous, red, and tender. A chest x-ray reveals no effusions or infiltrates, although there is minimal
atelectasis in both lower lung fields. Which of the following is the next best step in management?

A Thoracotomy and lobectomy
B MRI of the thorax
C Empiric antibiotics
D Thoracentesis
E Empiric systemic anticoagulation, followed by further imaging

Cardiology Cases