Discharge a PE? that ' s crazy talk!

So I recently sent home a patient with a Pulmonary Embolism (PE) for the first time. Or perhaps I should say that that it was the first time I ' ve < i > knowingly < /i > & nbsp;sent home a patient with a PE, but that ' s neither here nor there. < br / > < br / > This was an unusual case, to be sure. The patient was young and healthy, a triathlete in & nbsp;exceptional & nbsp;condition. He had had arthroscopic surgery on his left knee about a month ago, and a few days after that developed this sharp pleuritic left chest pain. The pain was quite severe, but he ignored it for about three weeks until finally, since it wasn ' t going away he presented to his doctor, who diagnosed the PE on CT and sent him to me for treatment. < br / > < br / > The PE was small but not tiny, segmental as I recall. He otherwise looked great, with no tachycardia or shortness of breath. Functionally, he was doing great. He wasn ' t back to running yet, but he was cycling and swimming and performing at about his usual level. So I guess that made him functionally " well-preserved. " Given that he had symptoms for over three weeks, I guess that qualified him as stable, so we started him on low molecular weight heparin (LMWH) and sent him home. < br / > < br / > And I suspect that this is where we are going in the future - outpatient management of stable PE patients. < br / > < br / > I threw out the question on twitter at 2AM, and woke to find a vigorous conversation ongoing on the topic among ER physi...
Source: Movin' Meat - Category: Emergency Medicine Source Type: blogs