Half-dose alteplase for sub-massive pulmonary embolism directed by emergency department point-of-care ultrasound

West J Emerg Med. 2015 Jan;16(1):181-3. doi: 10.5811/westjem.2014.12.24130. Epub 2015 Jan 12.


This report describes a patient with sub-massive pulmonary embolism (PE) who was successfully treated with half-dose thrombolytics guided by the use of point-of-care (POC) ultrasound. In this case, POC ultrasound was the only possible imaging since computed tomography was contraindicated. POC ultrasound demonstrated a deep vein thrombosis and evidence of cardiac strain. In situations or locations where definitive imaging is unobtainable, POC ultrasound can help diagnose submassive PE and direct the use of half-dose tissue plasminogen activator.

Publication types

  • Case Reports

MeSH terms

  • Emergency Service, Hospital*
  • Fibrinolytic Agents / administration & dosage*
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Male
  • Point-of-Care Systems*
  • Pulmonary Embolism / diagnostic imaging
  • Pulmonary Embolism / drug therapy*
  • Tissue Plasminogen Activator / administration & dosage*
  • Tissue Plasminogen Activator / therapeutic use
  • Ultrasonography, Interventional*


  • Fibrinolytic Agents
  • Tissue Plasminogen Activator