Age >18 years Symptomatic acute pulmonary embolism with first clinical symptoms within 15 days, and objectively confirmed by CT scan RV dysfunction confirmed by echocardiography or spiral CT of the chest:
▸ Echocardiography (≥1 criterion): RV/LV end-diastolic diameter >1 (apical or subcostal 4-chamber view)
▸ CT: right/left short-axis diameter ratio >0.9 (transverse plane)
▸ BNP >200 pg/mL or NT-pro BNP >600 pg/mL One abnormal PESI criteria:
▸ Heart rate >110/min
▸ Systolic blood pressure <100 mm Hg
▸ Arterial oxyhaemoglobin level <90%
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Cardiogenic shock requiring thrombolysis Significant LV insufficiency (LVEF <45%) Systolic blood pressure <90 mm Hg at admission Age ≤18 years Pregnancy No health insurance Patients deprived of liberty or under legal protection
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