Currently there is no clear guidance for the treatment of moderate risk of pulmonary embolism. The aim of the study is to compare two different therapeutic modalities - standard anticoagulation versus thrombolytic treatment followed by anticoagulation in standard regimen as stated in the pulmonary embolism guidelines.

Standard treatment of moderate risk pulmonary embolism constitutes of sole anticoagulation therapy. In case of troponin positivity and/or echocardiographic findings as i.e. thrombi in RV thrombolytic therapy should be considered. The aim of this trial is to compare the two treatment modalities in their ability to reduce/predict 12 month end-point: pulmonary hypertension, right ventricular failure, exercise capacity.

Inclusion Criteria:

• moderate risk pulmonary embolism as defined by the European Society of Cardiology /ESC/ guidelines
• signed informed consent

Exclusion Criteria:

• patient not willing to sigh informed consent
• absolute contraindication of thrombolysis
• inability to obtain meaningfull echocardiographic images¨
• pulmonary arterial hypertension
• known right ventricular failure