Effect of Thrombolysis on 30-day Mortality in Intermediate High Risk Pulmonary Patients With Low Bleeding Risk

Inclusion Criteria: * Patients with intermediate high risk pulmonary embolism diagnosed according to clinical probability using revised Geneva Score and diagnosis confirmed by echocardiography and Troponin I or T level and CT pulmonary angiography Exclusion Criteria: * o High risk PE * Intermediate low risk PE * low risk PE * Patients with left ventricular systolic dysfunction (ischemic or non-ischemic etiology) * Patients with chronic lung diseases (obstructive or restrictive) * Patients with contraindications to thrombolysis: * History of haemorrhagic stroke or stroke of unknown origin * Ischaemic stroke in previous 6 months * Central nervous system neoplasm * Major trauma, surgery, or head injury in previous 3 weeks * Bleeding diathesis (known inherited bleeding disorder, for example, haemophilia, platelet count \<50,000/uL) * Active bleeding * Transient ischaemic attack in previous 6 months * Oral anticoagulation * Pregnancy or first post-partum week * Non-compressible puncture sites * Traumatic resuscitation * Severe hypertension (systolic BP \>180 mmHg) * Advanced liver disease * Infective endocarditis * Active Peptic ulcer * Patients who develop hypotension or bradycardia or allergic reaction requiring discontinuation of Streptokinase infusion. * Patients with HAS-BLED score greater than or equals 3 (high bleeding risk for thrombolysis)