A patient with confirmed PE remains hypotensive at 78/46 mmHg after a cautious fluid challenge and requires norepinephrine. There is no major

Question

A patient with confirmed PE remains hypotensive at 78/46 mmHg after a cautious fluid challenge and requires norepinephrine. There is no major bleeding contraindication. What is the definitive escalation?

Accepted Answer

Begin reperfusion therapy with anticoagulation and monitored critical-care support

Answer

Use anticoagulation alone because thrombolysis is reserved for cardiac arrest

Answer

Insert an IVC filter as the primary treatment for obstructive shock

Answer

Give a large crystalloid bolus before considering thrombolysis because RV preload is always beneficial

Answer

Delay reperfusion until troponin and BNP are both elevated

Inferior STEMI with RV infarction — RCPSC EM MCQ

A patient with confirmed PE remains hypotensive at 78/46 mmHg after a cautious fluid challenge and requires norepinephrine. There is no major bleeding contraindication. What is the definitive escalation?