Historical collection · First published Feb 19, 2026; added to EM Weekly Oct 27, 2026. This retrospective summary may be superseded by later evidence or guidance.
← All articles2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
Summary
The first AHA/ACC multisociety acute PE guideline introduces categories A–E to connect severity with outpatient care, admission and advanced therapy. It emphasizes prompt anticoagulation and prefers DOACs over vitamin K antagonists when appropriate.
Why it matters
Use structured severity assessment for disposition and escalation, rather than clot size alone. Confirm outpatient treatment feasibility and arrange early follow-up; pregnancy requires a separate anticoagulant choice.
Study at a glance
- Design
- Guideline
- Population
- Adults with acute pulmonary embolism.
- Sample size
- Not applicable
- Intervention
- Risk classification, diagnostic, anticoagulation, disposition and advanced-treatment recommendations.
- Comparator
- Prior practice without a unified AHA/ACC acute PE guideline.
- Primary endpoint
- Guideline recommendations, not a single clinical-trial endpoint.
Main findings
- Categories A/B often permit outpatient care; C–E require hospitalization according to the official society summary.
- DOACs are preferred over vitamin K antagonists in eligible patients; DOACs are not recommended in pregnancy.
- Higher-risk patients may need multidisciplinary assessment for reperfusion or other advanced support.
Limitations
Many escalation decisions depend on bleeding risk, local expertise and evidence with variable certainty. The categories do not make every low-risk patient suitable for discharge or every high-risk patient suitable for intervention.
Recommendation strength
Primary guideline anticoagulation recommendations include Class 1, level B-R for anticoagulation and DOAC preference in eligible patients; advanced-treatment classes vary.
Read the primary source
Full text: Official PDF available.
Original source Official source PDFDOI: 10.1161/CIR.0000000000001415
Material reviewed: official society summary.
Source retrieved Oct 27, 2026. ACC official February 19 release reviewed; selected primary guideline anticoagulation tables cross-checked. Complete guideline not reviewed. The JACC co-publication has PMID 41712898 and DOI 10.1016/j.jacc.2025.11.005; do not create a second record for it.
Corrections & review history
No corrections recorded. Human review: not yet human-reviewed.