Presentation

Kylie Brooks, a 43-year old woman, has been brought to the Emergency Department by her partner. She complains of acute chest pain and difficulty breathing. You try to establish the events that led to her symptoms by taking a short history.

Kylie tells you that she is in excellent health. She prides herself in her daily exercise routine and healthy diet. She was feeling fine a few days ago. In fact she just returned from Japan, where she attended her best friend's wedding. She noticed some calf pain a few days after she came back but did not think much of it since it subsided. She notes that the pain came back earlier today and she was awoken by chest pain a few hours ago. She got particularly concerned after she coughed up blood. 

You establish that she is not taking any medication, except for the 'pill', which she has taken for the past seven years. Both her mother and grandmother had deep vein thrombosis.

You suspect that this is a case of pulmonary embolism. Considering the fact that Kylie is hemodynamically stable (Blood pressure: 140/85mmHg; Heart rate: 75bpm), you decide to start anticoagulation treatment with an oral medication.

Which medication was most likely administered?