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After having studied nine observations about patients referred to them for embolectomy under CEC on suspicion of massive pulmonary embolism, the authors describe five differential diagnosis and how they can be reached. A low central venous pressure, an hypoxaemia sensitive to oxygenotherapy, a high pulmonary wedge pressure or the lack of diastolocapillary gradient, and, last of all, a real hypocoagulability attained by the use of low and daily doses of heparin must make one cautious. Yet, if a doubt should persist, an angiography and/or a scintigraphy will be asked for.
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