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Just published February 19th, 2026, the American College of Cardiology, along with the American Heart Association's newest guideline on the Evaluation and Management of Acute Pulmonary Embolism in Adults. 

This guideline provides comprehensive recommendations for the evaluation, management, and follow-up of adult patients with acute pulmonary embolism, or PE. 

Today we’ll be going over the 10 top take-home messages, so for the full guideline and recommendations, make sure to check it out on guidelinecentral.com

Let’s get started. 

  1. A new clinical classification scheme is presented, entitled “Acute Pulmonary Embolism Clinical Categories,” with 5 categories and subcategories, ranging from low to high risk for adverse outcomes, in order to enhance the precision of severity classification, prognosis assessment, and evidence-based therapeutic decision-making for patients presenting with acute PE.
  2. Patients with acute PE who are asymptomatic can safely be discharged home from the emergency room and do not need to be hospitalized.
  3. Early hospital discharge is generally recommended for patients with acute PE who are symptomatic but have a low clinical severity score.
  4. Symptomatic patients with acute PE and an elevated clinical severity score, including those with elevated biomarkers and/or right ventricular dysfunction , incipient cardiopulmonary failure, and those with cardiopulmonary failure characterized by persistent hypotension should be hospitalized to optimize treatment strategies.
  5. Advanced therapies, including systemic thrombolysis, catheter-based thrombolysis, mechanical thrombectomy, and surgical embolectomy are reasonable for patients with acute PE in Category E1 and can be considered  for patients with acute PE in PE Category D1-2.
  6. PE response teams are recommended to improve timeliness of care.
  7. In patients with acute PE who require initial parenteral anticoagulant therapy, low-molecular-weight heparin is recommended over unfractionated heparin.
  8. In patients with acute PE who are eligible for oral anticoagulation, direct oral anticoagulants are recommended over vitamin K antagonists, unless contraindicated, to prevent recurrent venous thromboembolism and reduce major bleeding.
  9. In patients with a first acute PE without a major reversible risk factor and in those with a persistent risk factor, continuing anticoagulation beyond the initial treatment phase into the extended phase is recommended.
  10. Patients who have had acute PE should be asked about PE-related symptoms and functional limitations at every visit for at least 1 year to screen for chronic thromboembolic pulmonary disease or other causes of dyspnea and functional limitation.

And there you have it. Make sure to check out the full guideline from the American College of Cardiology/American Heart Association and other related clinical decision support tools at guidelinecentral.com.

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