DIET & NUTRITION 
PATIENT EDUCATION 
OBESITY/WEIGHT MANAGEMENT 
EXERCISE/TRAINING 
LEGAL MATTERS 
GUIDELINES/RECOMMENDATIONS The AHA and ACC released joint clinical practice guidelines for acute pulmonary embolism, covering diagnosis, risk stratification, treatment, and follow-up across all care settings. The guidelines introduce a new five-category classification system (A-E) to guide disposition decisions for the approximately 470,000 Americans hospitalized with PE annually, with 1 in 5 high-risk patients not surviving.
Clinical Considerations
- Categories A-B patients with low-risk PE may be safely discharged from the ED and managed as outpatients under the new framework
- DOACs are now preferred over warfarin for most patients; low-molecular-weight heparin remains the standard for pregnancy
- All discharged patients require follow-up within one week, with a three-month visit to reassess anticoagulation duration and symptom burden
- Patients should be screened for at least one year for chronic thromboembolic pulmonary disease at every visit
Practice Applications
- Apply the new A-E classification at initial evaluation to determine appropriate care setting
- Screen all PE patients at follow-up for depression, anxiety, and PTSD
- Counsel women of childbearing age on contraception and anticoagulation options during potential pregnancy
- Reassess risks and benefits of continued anticoagulation at every visit beyond three to six months
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