Although post-operative acute pulmonary embolism (PE) is relatively rare, it poses a substantial risk of morbidity and mortality. We report the case of a 45-year-old hypertensive woman who presented with acute chest pain and dyspnoea eight days following a hysterectomy. On admission, she was tachycardic, hypotensive, and hypoxic. Transthoracic echocardiography revealed right ventricular dilation, a reduced tricuspid annular plane systolic excursion (TAPSE) of 12 mm, and a positive McConnell sign. Her Computed tomography pulmonary angiography confirmed bilateral pulmonary emboli. Due to a recent major surgery, systemic thrombolysis was contraindicated. Catheter-directed thrombolysis (CDT) was initiated, administering alteplase at 1 mg/hour per catheter. The patient demonstrated rapid clinical improvement, with marked reduction in oxygen and vasopressor support. She was discharged on rivaroxaban and resumed normal activities within one week. This case underscores the efficacy of CDT as a life-saving alternative in high-risk post-operative PE, especially in resource-constrained settings. Keywords: Pulmonary embolism, Thrombolysis, Echocardiography.

Background: Coronary Artery Disease (CAD) is a complex interaction of genetic and multifactorial environmental factors. This study was conducted to evaluate the association of blood groups with the severity of coronary artery lesions in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention (PCI). Methods: This descriptive cross-sectional study was conducted at a tertiary cardiac care center in Karachi, Pakistan. Consecutive adult patients of either gender diagnosed with ST-segment elevation myocardial infarction (STEMI) undergone primary PCI during the study period of November 2020 to February 2021 were included. Based on blood grouping patients were stratified into two groups, non-O and O. comparative analysis of clinical and angiographic findings was performed and Chi-square test was used with p-value ≤ 0.05 was considered statistically significant. Results: A total of 398 patients were included in this study out of which 296(74.4%) were males (mean age: 57.15±10.95 years) and 102(25.6%) females. Type O blood group distribution was 107(26.9%) and non-O blood groups were 291(73.1%). The non-O blood group included A=110(27.6%), AB=43(10.8%), and B=138(34.7%). Significant results in type O and non-O group were seen among single vessel diseases (41.1%, 29.6%) (p=0.029) and circumflex artery as culprit (16.8%,9.6%) (p=0.046), whereas in post-procedure complication no significant results were found (p=0.554) with in-hospital mortality rate (p=0.642). Conclusion: Blood group type O was found to be associated with single-vessel coronary artery diseases. However, no association of blood groups was observed with lesion complexity, post-procedure complications and mortality. Keywords: Ischemic Heart Diseases; Coronary Artery Diseases; Myocardial Infarction; Blood Group.