Pulmonary Embolism USMLE Step 1 Practice Question
A 42-year-old woman with no prior thromboembolism presents with sudden-onset pleuritic chest pain, dyspnea, and syncope. Vital signs show BP 95/62, HR 118, RR 24, SpO2 88% on room air, temperature 37.2°C. Physical exam reveals elevated JVP and loud P2. ECG demonstrates right axis deviation and peaked T waves in lead III. Chest X-ray shows no infiltrates. D-dimer is markedly elevated at 2.8 mcg/mL. Which of the following is the most likely diagnosis?
Answer choices
- ATension pneumothorax
- BPrimary pulmonary hypertension
- CAcute pericarditis with tamponade
- DAcute myocardial infarction of the right ventricle
- EMassive pulmonary embolism with hemodynamic compromiseCorrect answer
- FAcute decompensated heart failure with pulmonary edema
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