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
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?
Ventilation perfusion scan
CT pulmonary angiogram