Lytic therapy in pulmonary embolism:

C. Can be considered for hemodynamically unstable patients

DISCUSSION: Thrombolytic therapy in pulmonary embolism involves use of streptokinase or urokinase. This therapy is indicated for hemodynamic compromise from documented pulmonary embolism that has not responded to anticoagulation and inotropic support. Additionally, lytic therapy is contraindicated after neurosurgery or cranial trauma and in persons who have a history of internal bleeding or hemorrhagic cerebral infarction. The majority of patients with documented pulmonary embolism do not require lytic therapy.