338 Thrombolytic therapy in pulmonary embolism

IntroductionPulmonary embolism (PE) is a relatively common cardiovascular emergency. PE is a difficult diagnosis that may be missed because of non-specific clinical presentation. Non invasive investigations are compulsory to confirm PE. The management of PE is now well codified especially massive PE.Observations2 women aged respectively of 28 and 34 years, hospitalized in our hospital for massive pulmonary embolism with poor hemodynamic state. For the first patient the diagnosis is confirmed by TTE showing thrombus in the right atrium and left pulmonary artery and by computed tomography angiography. The two patients received thrombolytic treatment by recombinant tissue plasminogen activator (rtPA) with favorable outcome.ConclusionThrombolytic therapy is the first-line treatment in patients with high-risk PE presenting with cardiogenic shock and/or persistent arterial hypotension, with very few absolute contraindications