Treatment of acute pulmonary embolism: a comparison of international guideline recommendations.

Pulmonary embolism is a common cardiovascular cause of death. Following diagnosis, immediate risk stratification and initiation of treatment are crucial but challenging, as patients may rapidly deteriorate in cases of progressive right heart failure. Multiple approaches to standardized risk stratification and subsequent management have been proposed, including assessment of clinical parameters such as cardiac biomarkers and imaging evidence of right ventricular abnormalities; however, obtaining an overview of the strengths and weaknesses of the multiple proposed approaches to risk stratification and subsequent management might be overwhelming for physicians not routinely involved in the treatment of acute pulmonary embolism. Fourteen international guidelines have been authored by medical societies or expert author groups over the past 20 years, offering recommendations on aspects of the management of pulmonary embolism, some of which are characterized by notable heterogeneity. This review summarizes and compares the main recommendations of each guideline, considers the most recent evidence for each topic, and provides a synthesis of the most common recommendations.