On Feb. 19, 2026, the American Heart Association (AHA) and the American College of Cardiology (ACC) jointly published the 2026 Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults.
According to the AHA press release, early detection and prompt treatment of acute pulmonary embolism (PE) is critical. Approximately 470,000 people are hospitalized with PE every year in the United States, and about one in five high-risk patients die from PE.
Prompt diagnosis of acute PE is essential for timely treatment, which can prevent severe complications such as cardiac arrest and death. However, timely diagnosis of acute PE is often challenging because many symptoms, such as shortness of breath, chest pain, rapid heartbeat, fainting and/or dizziness, are similar to symptoms for other conditions.
The new clinical practice guideline, which was published in Circulation, provides comprehensive recommendations for PE diagnosis, management and follow-up care. It acknowledges that implementation of its recommendations depends on the availability of local resources.
“There have been significant advances in the understanding of pulmonary embolism and treatments to effectively manage this condition. This guideline is a roadmap to help clinicians navigate these advances for the safest and most effective approaches to care for people with this condition,” said Mark A. Creager, MD, FAHA, FACC, chair of the guideline writing committee. Dr. Creager is a professor of medicine at the Geisel School of Medicine at Dartmouth College in Hanover, New Hampshire, and director emeritus of the Heart and Vascular Center at Dartmouth Health in Lebanon, New Hampshire.
The guideline also introduces new Acute Pulmonary Embolism Clinical Categories to define the severity of an acute PE and assist in developing a treatment strategy for adults with this condition. The system is organized into five categories (A–E), based on a patient’s severity of symptoms and risk for adverse outcomes:
- Patients in Categories A and B have no or mild symptoms and low risk of experiencing severe complications; they often can be safely discharged from the emergency department.
- Patients in Categories C, D and E have symptoms of acute PE and higher risk of adverse outcomes; they often require hospitalization.
Additional highlights from the guideline include:
- Detailed risk factors for acute PE, such as recent surgery or hospitalization, trauma, prolonged immobility, pregnancy, obesity, cancer and blood clotting disorders.
- Diagnostic strategies and treatment options to improve outcomes for patients with acute PE depending on the care setting, such as emergency department, inpatient care or outpatient clinic.
- Approaches to follow-up care, such as physical activity, travel considerations and long-term use of anti-clotting medications.
“We anticipate that decisions guided by these recommendations will result in more rapid diagnosis and application of effective, evidence-based treatments, leading to better outcomes, such as decreased risk of death and disability, for people with acute pulmonary embolism,” Dr. Creager said.
