By Melissa Hickson
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This is a V/Q lung scan, showing posterior (POST), left posterior oblique (LPO), right posterior oblique (RPO), and anterior (ANT) views. This is a type of imaging using scintigraphy to evaluate the air and blood within a patient’s lungs. The perfusion scan is abnormal, showing multiple peripheral perfusion defects in both lungsThe scan suggests normal ventilation, indicating unmatched ventilation-perfusion. There is therefore a high probability of pulmonary embolism (PE) in this patient. Other investigations may have included a chest radiaograph (to exclude pneumonia or pneumothorax), a D-dimer test and a CTPA. ECG should also be carried out, and may show RV strain and the classic S1,Q3,T3 appearance. Anticoagulation with unfractionated heparin (e.g. clexane 1.5mg/kg) and introduction of warfarin is indicated. Thrombolysis or surgical embolectomy may be indicated with very severe cases of PE.