Pulmonary embolism (PE) is a common and life-threatening disease. The incidence of a first episode of PE in acute care hospitals in the United States has been found to be 0.23 per 1000 with in-hospital mortality ranging from 30%, in case of cardiogenic shock, to about 0% in absence of right ventricular overload or hemodinamic impairment (1). In the intermediate group of patients with right ventricular overload but no hemodinamic impairment, in hospital mortality has been assessed to be about 5%. Right ventricular dysfunction as assessed at echocardiography and serum levels of Troponin I and T have been proposed as qualifying criteria for the identification of a subgroup of patients with pulmonary embolism and no hemodinamic impairment at high risk for in-hospital death. These patients could potentially benefit from more aggressive treatment.