Debating Anticoagulation and Thrombolysis for Pulmonary Embolism

Heparin is essential as it prevents clots from forming, not breaking them up. Despite its use before evidence-based medicine, it is deeply ingrained in medical practice for PE. Timing of heparin initiation may not significantly impact outcomes. When considering thrombolysis, it is essential to weigh the decision to start heparin accordingly. Thrombolysis is beneficial for massive PE, but its long-term benefits for chronic thromboembolic pulmonary hypertension are controversial. The primary goal of thrombolysis is to prevent sudden cardiac arrest or stabilize patients in hemodynamic compromise. The evidence for thrombolysis in PE remains murky, focusing on patients at the brink of hemodynamic compromise to avoid deterioration and cardiac arrest. The importance of timely administration and individual patient assessment is crucial amidst the existing controversy and varying study results.