Venous thromboembolism in pregnancy Quiz: Ace Your Exams
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A 30-year-old woman, gravida 2 para 1, at 24 weeks of gestation, presents to the obstetrics clinic with a 6-hour history of sudden-onset dyspnea and pleuritic chest pain. There is no fever, cough, or hemoptysis. The patient has a history of cesarean delivery and is otherwise healthy. The only medication is a prenatal vitamin, and family history is unremarkable. The patient does not smoke and works a sedentary job. Temperature is 37.0°C (98.6°F), heart rate 110/min, respirations are 22/min, blood pressure is 120/80 mmHg, and oxygen saturation 91% on room air. Physical examination reveals mild jugular venous distention and crackles in the left lower lung field. There is mild left calf swelling and tenderness. The remainder of the exam is unremarkable. Which of the following is the most appropriate initial test?
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