What are guidelines for use of thrombolytic therapy for pulmonary embolism (PE)?

Updated: Dec 31, 2017
  • Author: Wanda L Rivera-Bou, MD, FAAEM, FACEP; Chief Editor: Erik D Schraga, MD  more...
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Answer

Answer

The ninth edition of the American College of Chest Physicians (ACCP) guidelines for antithrombotic and thrombolytic therapy recommended the use of thrombolytic therapy in patients with acute PE associated with hypotension and in a subgroup of patients who are hemodynamically stable at presentation but are at high risk for hypotension. [30]

Clinical evidence of instability in this subgroup of patients could present as a decrease in systolic BP that remains above 90 mm Hg, tachycardia, poor tissue perfusion, RV dysfunction or enlargement, worsening respiratory insufficiency or major myocardial necrosis.


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