To assess the cardiopulmonary status of a patient suspected of having PE, various steps should be taken. This includes conducting a comprehensive evaluation of the patient’s medical history, performing a physical examination, and utilizing diagnostic tests. Although individual clinical and laboratory parameters may lack specicity, the presence of signicant manifestations indicative of PE can guide the decision to proceed with further diagnostic studies. Several assessments should be conducted during the evaluation process. This includes reviewing chest radiographs and electrocardiograms to rule out acute myocardial infarction and arrhythmias, as well as to evaluate signs of right ven­tricular strain such as P-pulmonale, right-axis deviation, right bundle branch block, or S1Q3T3 pattern. Other diag­nostic tests, such as CT pulmonary angiography and right heart pressure monitoring, can provide valuable informa­tion. Pulmonary capillary wedge pressure is particularly useful in ruling out right-sided heart failure. Measurement of right ventricular end-diastolic pressure and pulmonary artery pressure can help determine the degree of pulmonary hypertension. Additionally, it is important to check the patient’s serum electrolyte levels, blood urea nitrogen, and creatinine levels, coagulation parameters (partial thrombo­plastin time and prothrombin time), and platelet count. Arrhythmias should be managed with prophylactic lido­caine administered intravenously (50–100mg), and consul­tation with a cardiologist may be necessary. During the procedure, continuous cardiac monitoring is essential for all patients. It is crucial to be prepared to place and activate a transvenous pacer if the patient presents with a left bun­dle-branch block.