Guidelines on acute pulmonary embolism from the European Society of Cardiology: reflections from the perspective of the emergency physician

The European Society of Cardiology published "Guidelines on the diagnosis and management of acute pulmonary embolism" at the end of 2008. This document provides an exhaustive review of the epidemiologic, diagnostic, therapeutic, and prognostic evidence related to acute pulmonary embolism. The aim of the present review is to synthesize the points of greatest interest for the emergency physician, with particular emphasis on the use of the various risk factors proposed. The guidelines suggest adopting clinical variables and signs of right ventricular dysfunction or markers of myocardial injury given their prognostic value, rather than applying traditional scales. The emergency echocardiograph to detect signs of right ventricular dysfunction probably has the greatest prognostic value in the emergency setting. This test is indispensable for emergency department physicians who manage patients suspected to be at high risk of pulmonary embolism. [Emergencias 2010;22:61-67]