What is the role of thrombolytic therapy in the treatment of cardiac arrest due to pulmonary embolism (PE)?

Updated: Aug 04, 2021
  • Author: Wanda L Rivera-Bou, MD, FAAEM, FACEP; Chief Editor: Erik D Schraga, MD  more...
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In the worst clinical scenario, PE can cause cardiac arrest. The most common cardiac arrest initial rhythms documented include pulseless electrical activity and asystole. Cardiac arrest in the event of PE carries a mortality of 66-95%.

Numerous case reports state the use of thrombolytic boluses in cardiac arrest due to PE, with apparent heroic results. According to the British Thoracic Society 2003 recommendations, immediate administration of 50 mg of alteplase may be lifesaving for patients in cardiac arrest believed to be caused by PE. The clinician’s focus should be on preventing the cardiac arrest and identifying patients who are candidates for thrombolytic therapy in the event of a PE.

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