A 74 years old male patient presented with a two days history of dyspnea, orthopnea, pleuritic chest pain, hemoptysis, and fever after a history of fall from his bed with 2 fractured ribs two days ago. On physical examination his heart rate was 120 beats per minutes, temperature 40°C and blood pressure 110/60 mmHg. Arterial oxygen saturation was 96% on air. No heart murmur was noted but there was decreased air entry in right lower lobe of the lung. Chest X-ray showed 3rd and 5th rib fractures on the right side as well as lower lobe consolidation. ECG showed sinus tachycardia. The D-dimer level was > 2000ng/mL (normal level < 500 ng/mL). Subcutaneous enoxaparin 40mg (twice daily) was started immediately. Pulmonary CT angiography revealed right pulmonary embolism. Subcutaneous enoxaparin was continued for a couple of days with daily international normalised ratio (INR) check until D-dimer level was < 500 ng/mL