ABSTRACT
This chapter presents a case study of a 30-year-old pregnant woman who comes in to the Emergency Department complaining of shortness of breath. This patient has a pulmonary embolism (PE). Dyspnoea, pleuritic chest pain and haemoptysis may all be features of the history, although symptoms can be absent. Collapse and central chest pain may indicate a massive PE. Blood tests should include an arterial blood gas, which classically shows respiratory alkalosis but may be normal with small PEs. Treatment with low molecular weight heparin (LMWH) must be administered immediately for all pregnant patients with a suspected venous thromboembolism (VTE), until a diagnosis is excluded, unless anticoagulation is strongly contraindicated. As this patient is hypoxic and tachycardic, she should be admitted for investigation and management until her observations stabilise. The patient should be followed up regularly in antenatal clinic upon discharge and where possible should be seen in an obstetric medicine or joint obstetric haematology clinic postnatally.
