MRCP2-4499
A 67-year old male with metastatic small cell lung cancer presents with an acutely swollen leg. An ultrasound scan reveals a femoral vein venous thrombosis. Later, he experiences tachypnea and drops his oxygen saturation level to 88% on air. On auscultation, there is wheezing bilaterally and reduced air on the left with hyper-resonant percussion note. An urgent CT thorax is requested, which shows a large 5 cm pneumothorax, bilateral segmental PEs, and a left-sided 4x3x2 cm lung cancer. Considering the risk of bleeding following insertion of a chest drain to treat the pneumothorax, what decision should be made regarding his anticoagulation for PE?