In a patient with pulmonary embolism and normal ventricular function, what is the treatment of choice?

• A. Anticoagulation
• B. Embolectomy
• C. Thrombolysis
• D. Inferior vena cava filter

Answer: (A)

When a pulmonary embolism patient is hemodynamically stable with normal ventricular function, the main approach is anticoagulation. This choice prevents further clot growth and new emboli, reducing mortality and recurrence without the bleeding risks tied to clot-dissolving therapies. Thrombolysis or surgical embolectomy is reserved for massive PE with shock or significant hemodynamic compromise, where rapid clot reduction is needed. An inferior vena cava filter is not first-line unless anticoagulation cannot be given or there is recurrent PE despite anticoagulation. Practically, start with anticoagulation (for example, heparin) and transition to an oral anticoagulant or a DOAC for several months based on risk factors.