Pulmonary embolism varies in presentation with factors such as embolus size and pre-existing comorbidities contributing significantly. Despite the availability of several options to treat pulmonary embolism, these options significantly decrease when a massive pulmonary embolism causes a cardiac arrest in the setting of a recent hemorrhage thalamic stroke. We reviewed the current literature and presented a case report. In addition, we presented seven cases of pulmonary embolus where thrombolysis was used despite an absolute contraindication to thrombolysis, and the patients had successful outcomes.