A 25-year-old white female reports to the Emergency Room because of sharp left-sided chest pain and shortness of breath of one-day duration. The patient was in excellent health until yesterday. She was awakened from her sleep by sharp left-sided chest pain. The pain worsened with motion and deep breathing. The pain has been progressively increasing in severity, and she now has severe left shoulder pain. She complains of shortness of breath and is very apprehensive about dying. She denies any cough, fever, sputum production, or hemoptysis.
She is married and had one normal delivery three years ago. She is currently on birth control pills. She has never been hospitalized except for labor and delivery. Review of systems is negative. She denies any past history of venous problems.
She reveals having a similar transitory minor episode of chest pain approximately one year ago while she was vacationing in Michigan.
She works as a computer programmer. She smokes one pack of cigarettes a day for the past eight years. She considers herself a social drinker.
What can you reasonably conclude given the above information:
(select all that apply)
A. She is at risk for a cerebral vascular accident due to brain embolism if the DVT moves to her brain.
B. Her history, signs, and symptoms are consistent with a pulmonary embolism due to an embolized DVT.
C. Smoking and a sedentary job that requires hours of sitting have increased her risk for deep vein thrombosis.
D. Underlying pathology was most likely due to turbulence (vs stasis) of venous flow.
E. If blood flow from the right ventricle is significantly impeded, as in a saddle thrombus, she could be at risk for cardiovascular collapse.