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In high-risk PE, time is critical → mortality is high if untreated. • Do NOT delay reperfusion therapy waiting for CT if patient is unstable and signs of PE are strong. • Echo is not diagnostic, but used as quick support for decision-making when CT is not immediately possible. High-risk PE (shock/hypotension) → If CT available → Confirm, treat if positive If CT not available → Echo RV overload no other cause → Thrombolysis/Embolectomy justified No RV overload or CT negative → Search for other ca
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