For suspected massive pulmonary embolism causing cardiac arrest, which therapy may be initiated?

For suspected massive pulmonary embolism causing cardiac arrest, which therapy may be initiated?

• A. Fibrinolytic therapy
• B. Beta-blockers
• C. Antiplatelet monotherapy
• D. Calcium channel blockers

Answer: (A)

Massive pulmonary embolism during cardiac arrest is an obstructive crisis where a large clot blocks blood flow through the lungs, leading to sudden loss of circulation. In this scenario, dissolving the clot quickly is the most effective way to restore pulmonary perfusion and improve chances of return of spontaneous circulation. Fibrinolytic therapy administers a thrombolytic agent to dissolve the fibrin in the embolus, addressing the root cause of the arrest rather than merely modulating heart rate or blood pressure. This approach is supported in ACLS when PE is suspected as the cause and there are no contraindications to thrombolysis. Other options don’t fit the situation because they don’t rapidly resolve the obstructing clot: beta-blockers would reduce cardiac output and are not helpful in shock; calcium channel blockers can worsen hypotension; antiplatelet monotherapy isn’t effective against large venous thrombi. If thrombolysis is not possible due to contraindications, surgical or catheter-directed thrombectomy may be considered.

Massive pulmonary embolism during cardiac arrest is an obstructive crisis where a large clot blocks blood flow through the lungs, leading to sudden loss of circulation. In this scenario, dissolving the clot quickly is the most effective way to restore pulmonary perfusion and improve chances of return of spontaneous circulation. Fibrinolytic therapy administers a thrombolytic agent to dissolve the fibrin in the embolus, addressing the root cause of the arrest rather than merely modulating heart rate or blood pressure. This approach is supported in ACLS when PE is suspected as the cause and there are no contraindications to thrombolysis.

Other options don’t fit the situation because they don’t rapidly resolve the obstructing clot: beta-blockers would reduce cardiac output and are not helpful in shock; calcium channel blockers can worsen hypotension; antiplatelet monotherapy isn’t effective against large venous thrombi. If thrombolysis is not possible due to contraindications, surgical or catheter-directed thrombectomy may be considered.