Tissue Plasminogen Activator Use for Pulmonary Embolism

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63% of patients thought to have had a pulmonary embolus had no evidence, making it both underdiagnosed in some clinical settings yet overdiagnosed in others(Stein and Henry 1995). The normal presentation is acute onset chest pain associated with shortness of breath. A preceding history of deep venous thrombosis may be present. The patient is usually tachycardic and may be hypoxic and hypotensive. Over 70% of patients with pulmonary embolism present with DVT(SAEGER W 1994), often caused by immobilization, recent trauma, and surgery (particularly of the lower limbs). Other risk factors include long]distance air travel, inherited clotting disorders or contraceptive pill use in women who smoke or are diabetic (Goldhaber 2009).
For general purposes pulmonary embolism is categorized by onset (acute or sub-acute), and hemodynamic response (massive or sub-massive). The hemodynamic response to pulmonary embolism depends upon a number of factors, including the size of the embolus, ...

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