A 64-year-old man is admitted with sudden dyspnoea, hypotension (BP 80/50 mm Hg), tachycardia and syncope. CT pulmonary angiography confirms a massive...

Question

A 64-year-old man is admitted with sudden dyspnoea, hypotension (BP 80/50 mm Hg), tachycardia and syncope. CT pulmonary angiography confirms a massive pulmonary embolism with right ventricular strain. There are no absolute contraindications to thrombolysis. What is the most appropriate immediate treatment?

Accepted Answer

Systemic thrombolysis with intravenous alteplase

Answer

Low-molecular-weight heparin alone

Answer

Inferior vena cava filter insertion only

Answer

Oral anticoagulation with a direct oral anticoagulant

Answer

Urgent surgical embolectomy in all cases

ca-mccqe1 MCQ (SBA): Massive pulmonary embolism management