To Give or Not to Give: Thrombolysis for Massive Pulmonary Embolism in a Patient with Profound Anaemia

Massive pulmonary embolism (PE) is uncommon but potentially fatal, requiring immediate thrombolytic therapy. Thrombolysis, however, carries a significant bleeding risk and is generally contraindicated in cases of active bleeding, which is an important differential to consider in patients with severe anaemia. Physicians must balance possible bleeding against the risk of rapid clinical deterioration. We report a case of autoimmune haemolytic anaemia presenting with massive PE and profound anaemia successfully treated with thrombolysis.