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Volume 347:1131-1132 October 10, 2002 Number 15 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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The primary therapy for acute pulmonary embolism is anticoagulation with heparin and warfarin to prevent additional thromboembolism. Traditional teaching relegates the use of thrombolysis to the rare situation in which massive pulmonary embolism causes cardiogenic shock. Thrombolytic agents such as alteplase (recombinant tissue plasminogen activator) act on plasminogen by cleaving the peptide bond between arginine at position 560 and valine at position 561, thereby converting plasminogen to plasmin, which dissolves the embolus. Should we expand the indications for thrombolysis to encompass pulmonary embolism in patients with right ventricular dysfunction, even in the presence of normal systemic arterial pressure (see Figure. . . [Full Text of this Article]

Related Letters:

Thrombolytic Therapy in Patients with Submassive Pulmonary Embolism
Ashton R. W., Daniels C. E., Ryu J. H., Gunn N. A., Tierney L. M. Jr., Berlin D. A., Dalen J. E., Ajani A. E., Waksman R., Konstantinides S., Kasper W.
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N Engl J Med 2003; 348:357-359, Jan 23, 2003. Correspondence

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