These factors include persistent hypotension or shock despite resuscitation, new or worsening right ventricular (RV) dysfunction detected through various diagnostic methods, elevated biomarkers such as troponin and BNP, a high simplified Pulmonary Embolism Severity Index (sPESI) score, a high clot burden, proximal deep venous thrombosis, significant hypoxemia, tachycardia, poor cardiopulmonary reserve, and the presence of a right-sided cardiac thrombus. Here, NPPB is linked to pulmonary embolism.