Abbreviations and acronyms
Preamble
Introduction
- Why do we need new Guidelines on the diagnosis and management of pulmonary embolism?
- What is new in the 2019 Guidelines?
- New/revised concepts in 2019
- Changes in recommendations 2014_19
- Main new recommendations 2019
General considerations
- Epidemiology
- Predisposing factors
- Pathophysiology and determinants of outcomes
Diagnosis
- Clinical presentation
- Assessment of clinical (pre-test) probability
- Avoiding overuse of diagnostic tests for pulmonary embolism
- D-dimer testing
- Age-adjusted D-dimer cut-offs
- D-dimer cut-offs adapted to clinical probability
- Point-of-care
- D-dimer assays
- Computed tomographic pulmonary angiography
- Lung scintigraphy
- Pulmonary angiography
- Magnetic resonance angiography
- Echocardiography
- Compression ultrasonography
- Computed tomography venography
Assessment of pulmonary embolism severity and the risk of early death
- Clinical parameters of pulmonary embolism severity
- Imaging of right ventricular size and function
- Echocardiography
- Computed tomographic pulmonary angiography
- Laboratory biomarkers
- Markers of myocardial injury
- Markers of right ventricular dysfunction
- Other laboratory biomarkers
- Combined parameters and scores for assessment of pulmonary embolism severity
- Integration of aggravating conditions and comorbidity into risk assessment of acute pulmonary embolism
- Prognostic assessment strategy
Treatment in acute phase
- Haemodynamic and respiratory support
- Oxygen therapy and ventilation
- Pharmacological treatment of acute right ventricular failure
- Mechanical circulatory support and oxygenation
- Advanced life support in cardiac arrest
- Initial anticoagulation
- Parenteral anticoagulation
- Non-vitamin K antagonist oral anticoagulants
- Vitamin K antagonists
- Reperfusion
- Systemic thrombolysis
- Percutaneous catheter-directed treatment
- Surgical embolectomy
- Multidisciplinary pulmonary embolism teams
- Vena cava filters
Integrated risk-adapted diagnosis and management
- Diagnostic strategies
- Suspected pulmonary embolism with haemodynamic instability
- Suspected pulmonary embolism without haemodynamic instability
- Strategy based on computed tomographic pulmonary angiography
- Strategy based on ventilation/perfusion scintigraphy
- Treatment
- Emergency treatment of high-risk pulmonary embolism
- Treatment of intermediate-risk pulmonary embolism
- Management of low-risk pulmonary embolism: triage for early discharge and home treatment
Chronic treatment and prevention of recurrence
- Assessment of venous thromboembolism recurrence risk
- Anticoagulant-related bleeding risk
- Regimens and treatment durations with non-vitamin
- K antagonist oral anticoagulants, and with other non-vitamin K antagonist antithrombotic drugs
- Management of pulmonary embolism in patients with cancer
Pulmonary embolism and pregnancy
- Epidemiology and risk factors for pulmonary embolism in pregnancy
- Diagnosis of pulmonary embolism in pregnancy
- Clinical prediction rules and D-dimers
- Imaging tests
- Treatment of pulmonary embolism in pregnancy
- Role of a multidisciplinary pregnancy heart team
- Amniotic fluid embolism
Long-term sequelae of pulmonary embolism
- Persisting symptoms and functional limitation after pulmonary embolism
- Chronic thromboembolic pulmonary hypertension
- Epidemiology, pathophysiology, and natural history
- Clinical presentation and diagnosis
- Surgical treatment
- Balloon pulmonary angioplasty
- Pharmacological treatment
- Strategies for patient follow-up after pulmonary embolism
Non-thrombotic pulmonary embolism
Key messages
Gaps in the evidence
‘What to do’ and ‘what not to do’ messages from the Guidelines
Supplementary data
Appendix
References
Supplementary data