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The ACC/AHA published new guidelines for managing acute PE on February 19, 2026. Today I'm joined by Dr. Scott Woller, MD, MACP, FCCP, who was co-chair of the American College of Chest Physicians Clinical Practice Guideline for antithrombotic therapy for venous thromboembolism, last updated in 2021. He also served as co-chair for the peer review committee for these new guidelines, and has lots of great insights into how to use them in clinical practice and research.

2026 ACC/AHA Guidelines for Diagnosis and Managing Acute PE

Some highlights from the guidelines:

New categories of PE:
- A: asymptomatic
- B: symptomatic, low risk
- C: symptomatic, high risk
- D: incipient shock
- E: cardiogenic shock
PE response teams (PERTs) are ascendant
Use enoxaparin instead of heparin drip!
Advanced therapies for category D and E
Half dose DOACs for extended treatment
Shared decision making for clots provoked by minor risk factors
Patients with persistent symptoms need evaluation for CTEPD

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