BOF 70

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BOF: 70

A 76 year old male presents with a history of breathlessness and right sided pleuritic chest pain. Two weeks prior to admission he had undergone a left knee replacement. He was a known hypertensive on treatment with a thiazide diuretic.

On examination he was in distress and breathless, pulse 110 beats per minute BP 120/80 JVP not elevated HS were normal, no murmurs and his lungs were clear.

Chest X-ray showed scarring from previous pulmonary tuberculosis and the right costophrenic angle was obliterated.

Blood gases pH 7.46 Pa CO₂ 3.2 kPa, PaO₂ 8.9 kPa, bicarbonate 20 mmol/L

In this patient which one of the following tests would you arrange to elucidate the diagnosis?

a)      Ventilation perfusion scan

b)      CT pulmonary angiogram

c)      Transthoracic ECHO

d)     D- dimer

e)      Transoesophageal ECHO

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