What is already knownBasic management of massive and submassive pulmonary embolism. We understand that hemodynamic instability starts with elevation in pulmonary artery pressures which leads to right ventricular failure, then left ventricular failure, and then hemodynamic collapse. Inhaled pulmonary vasodilators are mentioned in the literature but infrequently utilized due to lack of availability and/or logistical challenges.
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