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Samuel Z. Goldhaber, MD

Arch Intern Med. 2005;165:2197-2199.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

There is no clinical controversy about patients with massive pulmonary embolism (PE) and hemodynamic collapse. These patients warrant thrombolytic therapy unless contraindications preclude this management strategy. It is also clear that patients with PE who present with normal blood pressure and heart rate as well as normal right ventricular (RV) function will have excellent outcomes with anticoagulation therapy alone. The debate centers on patients with submassive PE who have RV dilatation and hypokinesis despite normal blood pressure. I will make the case for thrombolysis based on the available evidence to support this position. However, I advocate and am helping to organize an international trial of these patients, who fall between the 2 extremes, to provide a definitive answer to this ongoing issue.

Patients with PE who have moderate or severe RV dysfunction are not really hemodynamically stable. Their clinical course may lead to either recovery or . . . [Full Text of this Article]

AUTHOR INFORMATION

Author Affiliations: Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass.

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