Guideline summary · Respiratory · 8 min read
Pulmonary embolism: risk stratification
From pre-test probability to thrombolysis.
Key points
- Estimate pre-test probability with the Wells or revised Geneva score; apply PERC only in low-probability patients.
- Use D-dimer only when PE is unlikely; age-adjusted cut-offs improve specificity over 50.
- CT pulmonary angiography confirms the diagnosis in stable patients.
- High-risk PE (sustained hypotension) is treated with anticoagulation and systemic thrombolysis unless contraindicated.
- Bedside echo showing right ventricular dilatation supports treatment when the patient is too unstable for CT.
Summary based on the ESC 2019 guidelines for acute pulmonary embolism. A study aid, not a substitute for the current guideline or local protocols.
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