A 55-year-old man with a history of recent long-haul flight develops sudden onset dyspnea and pleuritic chest pain. He is hypotensive (BP 85/50 mmHg) and tachycardic (HR 120 bpm). ECG shows sinus tachycardia and non-specific ST-T wave changes. What is the most appropriate immediate next step in management?

✓ Correct Answer: Option D

This patient presents with a high-probability massive pulmonary embolism (PE) evidenced by hypotension and acute dyspnea. In hemodynamically unstable PE, systemic thrombolysis is indicated as an immediate life-saving measure to restore perfusion, even before definitive imaging confirmation.