2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism

ACS : acute coronary syndrome AMPLIFY : Apixaban for the Initial Management of Pulmonary Embolism and Deep-Vein Thrombosis as First-line Therapy aPTT : activated partial thromboplastin time b.i.d. : bis in diem (twice daily) b.p.m. : beats per minute BNP : brain natriuretic peptide BP : blood pressure CI : confidence interval CO : cardiac output COPD : chronic obstructive pulmonary disease CPG : Committee for Practice Guidelines CRNM : clinically relevant non-major CT : computed tomographic/tomogram CTEPH : chronic thromboembolic pulmonary hypertension CUS : compression venous ultrasonography DSA : digital subtraction angiography DVT : deep vein thrombosis ELISA : enzyme-linked immunosorbent assay ESC : European Society of Cardiology H-FABP : heart-type fatty acid-binding protein HIT : heparin-induced thrombocytopenia HR : hazard ratio ICOPER : International Cooperative Pulmonary Embolism Registry ICRP : International Commission on Radiological Protection INR : international normalized ratio iPAH : idiopathic pulmonary arterial hypertension IVC : inferior vena cava LMWH : low molecular weight heparin LV : left ventricle/left ventricular MDCT : multi-detector computed tomographic (angiography) MRA : magnetic resonance angiography NGAL : neutrophil gelatinase-associated lipocalin NOAC(s) : Non-vitamin K-dependent new oral anticoagulant(s) NT-proBNP : N-terminal pro-brain natriuretic peptide o.d. : omni die (every day) OR : odds ratio PAH : pulmonary arterial hypertension PE : pulmonary embolism PEA : pulmonary endarterectomy PEITHO : Pulmonary EmbolIsm THrOmbolysis trial PESI : pulmonary embolism severity index PH : pulmonary hypertension PIOPED : Prospective Investigation On Pulmonary Embolism Diagnosis PVR : pulmonary vascular resistance RIETE : Registro Informatizado de la Enfermedad Thromboembolica venosa RR : relative risk rtPA : recombinant tissue plasminogen activator RV : right ventricle/ventricular SPECT : single photon emission computed tomography sPESI : simplified pulmonary embolism severity index TAPSE : tricuspid annulus plane systolic excursion Tc : technetium TOE : transoesophageal echocardiography TTR : time in therapeutic range TV : tricuspid valve UFH : unfractionated heparin V/Q scan : ventilation–perfusion scintigraphy VKA : vitamin K antagonist(s) VTE : venous thromboembolism Guidelines summarize and evaluate all available evidence at the time of the writing process, on a particular issue with the aim of assisting health professionals in selecting the best management strategies for an individual patient, with a given condition, taking into account the impact on outcome, as well as the risk-benefit-ratio of particular diagnostic or therapeutic means. Guidelines and recommendations should help the health professionals to make decisions in their daily practice. However, the final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate. A great number of Guidelines have …