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HardEmergencyMassive pulmonary embolismau-amcau-acem

A 64-year-old woman presents to the emergency department with sudden onset pleuritic chest pain and dyspnoea. She is hypotensive (BP 80/50 mmHg), tachycardic 130 beats/min and has elevated jugular venous pressure. CT pulmonary angiography confirms a massive pulmonary embolism. According to current recommendations, what is the most appropriate acute management?

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