Known Unknowns in the Contemporary Management of High-Risk Pulmonary Embolism: What Do the Guidelines Tell Us

Pulmonary embolism (PE) is a life-threatening condition with increasing hospital admissions. Prompt identification and treatment of PE patients with hemodynamic collapse are essential. Conflicting recommendations and weak evidence hinder effective management of PE, resulting in unchanged mortality rates despite advancements in therapies. Current risk stratification lacks granularity, necessitating a more detailed classification to guide treatment, predict outcomes, and improve patient selection for clinical trials. This article reviews clinical practice guidelines from major North American and European societies, emphasizing the need for more research and guidance to improve mortality and morbidity outcomes in PE.