A 55 year old man who has been on bed rest for the past 10 days, complain of breathlessness and chest pain. The chest X-ray is normal. The next step in the investigation should be –: (A) Lung ventilation – perfusion scan, (B) Pulmonary arteriography, (C) Pulmonary venous wedge angiography, (D) Echocardiography
Answer is A. This patient has a high clinical likelihood of pulmonary embolism because clinical assessment score is more than 4:-


Signs & symptoms of PE (Breathlessness & chest pain) → score 3.0
Immobilization (bed rest) > 3 days → score 1.5


So, the total score is 4.5. Therefore, imaging test should be done. CT contrast is the imaging test of choice.