Medical treatment of pulmonary embolism.

Anticoagulant treatment with heparin is definitely the most widely used therapeutic modality in pulmonary embolism. Its efficacy is conditioned by the need for an adequate level of anticoagulation to be rapidly attained. Thrombolytic therapy, as compared to heparin seem to favour a more rapid pertusion of obstructed arteries, a decrease in mean pulmonary pressure, a more rapid improvement in right ventricular function, with however no significant decrease in mortality. It is indicated in case of massive pulmonary embolism with or without shock or in case of perfusion defects in at least one lobe.