Abstract
Acute massive pulmonary embolism results in a rise in pulmonary vascular resistance and acute right ventricular dilation and systolic dysfunction. In unstable patients who cannot safely undergo computed tomography, echocardiography can often provide direct and indirect evidence of pulmonary embolism. We present a case in which clinical and echocardiographic evidence provided sufficient evidence of PE to initiate treatment. Dynamic improvement in hemodynamics and echocardiographic parameters of RV function indicated successful treatment.