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Pharmacology Hematology 8a8eee58

Treatment of choice in a patient of acute pulmonary embolism with right ventricular hypokinesia and a compromised cardiac output but normal blood pressure is:

A
Thrombolytic agent
B
Low molecular weight heparin
C
IV filters
D
Warfarin
High-Yield Explanation
Answer is option 1, thrombolytic agent Detection of right ventricular hypokinesis helps to stratify patients' risk, because right ventricular dysfunction confers a worse prognosis than does normal right ventricular function after PE. The concept of "hemodynamic instability" after PE should be expanded to include right ventricular dilatation and wall motion abnormalities, even among normotensive patients. Aggressive intervention with thrombolytic therapy, vasoactive agents, or mechanical embolectomy may improve right ventricular function and clinical outcome.

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