You decide that you need to exclude some common respiratory causes of chest pain and shortness of breath, so you decide to do an ABG and D-dimer. The results are as follows:

ABG:

• pH: 38                            (7.35 – 7.45)
• PaCO₂: 9 kPa                (4.7-6.0 kPa)
• PaO₂: 5 kPa                   (11-13 kPa)
• HCO₃-: 25 mEg/L           (22-26 mEg/L)

D-dimer:

388 ug/l (<345 ug/l)

 

What do you do next?

1) Immediate CT-pulmonary angiogram

2) Prescribe low molecular weight heparin (LMWH)

3) ECG and troponin