How to Diagnose a Massive Pulmonary Embolism

The American College of Chest Physicians, ASAP, the AHA and the European Society of Cardiology all recommend giving systemic littics to massive pulmonary embolism. There are limited studies showing that 50 milligrams may be just as good as 100 milligrams but we simply don't know. We should not be giving heparin and the thrombolytics together it's just a matter of when to start the heparin. The patient was healthy except for a bit of hypertension but clearly on the older side. So we decided to go with the smaller dose to 50 milligram of alti-place over about an hour. Over the next hour the patient appeared more