In cardiac arrest caused by pulmonary embolism, what therapy may be considered?

In cardiac arrest caused by pulmonary embolism, what therapy may be considered?

• A. Catheter-directed thrombolysis only
• B. Systemic thrombolysis is contraindicated
• C. Systemic thrombolysis or catheter-directed thrombolysis when indicated and no contraindications
• D. Immediate surgical embolectomy

Answer: (C)

When pulmonary embolism causes cardiac arrest, the priority is to rapidly dissolve or remove the clot to restore pulmonary blood flow. If there are no contraindications to thrombolysis, using a thrombolytic therapy is appropriate to dissolve the embolus and improve chances of return of spontaneous circulation. Both systemic thrombolysis and catheter-directed thrombolysis are valid options, and the choice can depend on bleeding risk, local protocol, and available expertise. Catheter-directed thrombolysis offers targeted clot dissolution and may be chosen when there is greater concern about systemic bleeding or when a faster local effect is desired; systemic thrombolysis treats clots throughout the pulmonary vasculature and is used when no contraindications exist. If thrombolysis is contraindicated or unavailable, or if it fails, surgical embolectomy is considered. Thus, thrombolysis—systemic or catheter-directed—when indicated and no contraindications, is the best approach.

When pulmonary embolism causes cardiac arrest, the priority is to rapidly dissolve or remove the clot to restore pulmonary blood flow. If there are no contraindications to thrombolysis, using a thrombolytic therapy is appropriate to dissolve the embolus and improve chances of return of spontaneous circulation. Both systemic thrombolysis and catheter-directed thrombolysis are valid options, and the choice can depend on bleeding risk, local protocol, and available expertise. Catheter-directed thrombolysis offers targeted clot dissolution and may be chosen when there is greater concern about systemic bleeding or when a faster local effect is desired; systemic thrombolysis treats clots throughout the pulmonary vasculature and is used when no contraindications exist. If thrombolysis is contraindicated or unavailable, or if it fails, surgical embolectomy is considered. Thus, thrombolysis—systemic or catheter-directed—when indicated and no contraindications, is the best approach.