Management of sub-segmental pulmonary embolism

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1. 55 year old female with suspected pulmonary embolism (PE) presents with shortness of breath to the emergency room. She has no leg symptoms. No transient risk factor for venous thromboembolism (VTE). She has no known malignancy. D-dimer is positive. Computed tomographic pulmonary angiography is performed and shows one single isolated filling defect within one sub-segmental pulmonary artery compatible with a single isolated sub-segmental PE. Compression leg vein ultrasonography of the proximal deep veins of both lower extremities is within normal limits. There are no contraindications to anticoagulation. What would be your next step?
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2. Identical features as Q1, except that the patient is known to have active metastatic ovarian cancer. What would be your next step?
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3. Identical features as Q1, except that the computed tomographic pulmonary angiography shows multiple filling defects within 2 sub-segmental pulmonary arteries compatible with multiple sub-segmental PE. What would be your next step?
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4. Identical features as Q1except that the computed tomographic pulmonary angiography shows a filling defect isolated within one segmental pulmonary artery compatible with single segmental PE. What would be your next step?
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5. Identical features as Q1 except that the computed tomographic pulmonary angiography shows a filling defect within the right upper lobe pulmonary artery compatible with lobar PE. What would be your next step?
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