Management of Pulmonary Embolism: The New European Guidelines
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Department of Cardiology, Democritus University of Thrace, Greece,
Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, Germany
Stavros Konstantinides   

Department of Cardiology Democritus University of Thrace University General Hospital 68100 Alexandroupolis, Greece
Pneumon 2014;27(4):294–299
Acute pulmonary embolism (PE) is the third most frequent acute cardiovascular syndrome, threatening the life of many patients worldwide and imposing a substantial economical burden on health systems. Recent evidence has led to significant progress in the management of the disease and provided a solid basis for the recommendations included in the 2014 update of the European Society of Cardiology Guidelines 2014 (endorsed by the European Respiratory Society). Advanced risk stratification of normotensive patients with ‘non-high-risk’ PE places an emphasis on clinical prediction rules and assessment of right ventricular function. In PE treatment, recently completed randomised trials using new oral (non-vitamin K-dependent) anticoagulants showed that these agents are at least as effective and probably cause less major bleeding than standard regimens. For intermediate-high-risk PE defined on the basis of imaging tests and laboratory biomarkers, the bleeding risks of full-dose thrombolytic treatment appear too high to justify its use unless clinical signs of haemodynamic decompensation appear. Overall, the new European Guidelines represent a comprehensive, multidisciplinary approach to PE, its acute complications, its management in specific patient populations, and its chronic sequelae such as chronic thromboembolic pulmonary hypertension. They provide a thorough and evidence-based, and at the same time practical and user-friendly guide to physicians involved in the management of PE.
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