What is new for internists in the updated guidelines on the diagnosis and management of pulmonary embolism 2019?

Overview

The new guidelines on the diagnosis and management of pulmonary embolism developed in collaboration with the European Respiratory Society were presented on the congress od European society of cardiology in 2019. Are internists concerned, when these guidelines were presented at the congress of cardiologic society? Management of acute pulmonary embolism is less „cathlab dependent“than management of acute coronary syndromes – and pulmonary embolism patients are often treated by internists. Moreover, differential diagnosis of dyspnoea is a everyday problem solved by internists. What is new in the updated guidelines? Refinements in interpretation of D‑dimer testing will help us to avoid unnecessary pulmonary angiograms. Non‑vitamin K antagonist oral anticoagulants (NOACs) are now the preferred agents for treating the majority of patients with PE, both in the acute phase and over the long term, including selected patients with malignancy. Further important updates include recurrence scores and guidance on extended anticoagulation after PE. A new comprehensive algorithm is proposed for patient follow‑up after acute PE to prevent, detect and treat late sequelae of venous thromboembolism. 

Keywords:

secondary prevention – guidelines – Pulmonary embolism – anticoagulation therapy