In a patient with massive thromboembolism with hypotension after a fluid bolus of 1 L, the patient’s blood pressure remains low at 88/50 mmHg.Echocardiogram demonstrates hypokinesis of the right ventricle.What is the next best step in management of this patient?
Treat with dopamine and recombinant tissue plasminogen activator, 100 mg IV Continue IV fluids at 500 mL/hr for a total of 4 L of fluid resuscitation. Refer for inferior vena cava filter placement and continue current management. Refer for surgical embolectomy.