مريضة بعد عملية ورك بخمسة أيام، فجأة صار عندها ضيق نفس وألم صدري ونبض ١١٨، وضغطها ٧٤/٤٠، والأوردة الوداجية منتفخة، وأشعة CT أكدت جلطة رئوية كبيرة. ما العلاج المتوقع غالباً؟

Five days after hip surgery a woman suddenly has dyspnoea, chest pain, HR 118, BP 74/40 and distended neck veins; CT confirms a large PE. What treatment is usually expected?

1. A broad antibiotic for a possible coexisting pneumonia
2. Oral aspirin with monitoring on the general ward
3. IV thrombolysis if there is no contraindication
4. An IV diuretic to relieve the jugular venous distension

Answer: C) IV thrombolysis if there is no contraindication. Massive PE with hypotension is high risk and treated with thrombolysis, catheter or surgical clot removal. Bleeding risk after recent surgery is weighed with the team. Diuretics would drop the pressure further.