A 61-year-old with suspected PE is hypotensive (SBP 78 mm Hg) with RV strain on echo. No contraindications to lysis. Best immediate therapy?...

Question

A 61-year-old with suspected PE is hypotensive (SBP 78 mm Hg) with RV strain on echo. No contraindications to lysis. Best immediate therapy?

Accepted Answer

Systemic thrombolysis with alteplase

Answer

Anticoagulation only and observe

Answer

Catheter-directed thrombolysis is mandatory first-line

Answer

Place an IVC filter primarily

Answer

Start dobutamine for RV support as sole therapy

us-usmle-step-2 MCQ (SBA): Massive Pulmonary Embolism