All Pathways
CardiologyDiagnostic

Pulmonary Embolism Risk Stratification (ESC/ERS 2019)

Pulmonary Embolism Risk Stratification (ESC/ERS 2019): Suspected PE → Hemodynamically Unstable? → HIGH-RISK PE → Anticoagulation.

Interactive Decision Tree

Mini Map

Algorithm Steps

  1. Start

    Suspected PE

    Clinical suspicion of pulmonary embolism

    1. Decision

      Hemodynamically Unstable?

      Cardiac arrest, shock, hypotension

      If Yes:

      1. Warning

        HIGH-RISK PE

        Immediate action required

        • Anticoagulation + PRIMARY REPERFUSION
        • Thrombolysis (Class I)
        • Surgical/catheter if lysis fails
        1. Action

          Anticoagulation

          DOAC preferred (Class I)

          • Apixaban or Rivaroxaban
          • LMWH over UFH for most
          • Duration: 3mo minimum

      If No:

      1. Action

        Calculate sPESI

        Simplified PE Severity Index

        • Age >80 (+1)
        • Cancer (+1)
        • Cardiopulm disease (+1)
        • HR ≥110 (+1)
        • SBP <100 (+1)
        • SpO2 <90% (+1)
        1. Decision

          sPESI Score?

          1. Action

            LOW RISK (sPESI 0)

            Consider home treatment

            • DOAC preferred
            • Close follow-up
            • Patient education
          2. Action

            sPESI ≥1

            Further stratify with RV + Troponin

            1. Decision

              RV Dysfunction + Troponin+?

              If Yes:

              1. Warning

                Intermediate-HIGH

                ICU, rescue reperfusion ready

              If No:

              1. Action

                Intermediate-LOW

                Ward, monitor closely

Guideline Source

2019 ESC/ERS Guidelines for Pulmonary Embolism

Clinical Safety Information

Clinical Decision Support — Not a Substitute for Clinical Judgment

Individual patient factors may require deviation from these recommendations.

Known Limitations

  • Wells score calculator not integrated
  • sPESI simplified
  • Does not address thrombolysis dosing

Contraindicated Populations

pediatricpregnancy

Applicable Regions

EUUS

EU: ESC/ERS 2019 guidelines

US: ACCP guidelines similar approach

Version 1Next review: 2026-01-01

Frequently Asked Questions

What is the Pulmonary Embolism Risk Stratification (ESC/ERS 2019)?

The Pulmonary Embolism Risk Stratification (ESC/ERS 2019) is a diagnostic clinical algorithm for Cardiology. It provides a structured decision tree to guide clinical decision-making, based on 2019 ESC/ERS Guidelines for Pulmonary Embolism.

What guideline is the Pulmonary Embolism Risk Stratification (ESC/ERS 2019) based on?

This algorithm is based on 2019 ESC/ERS Guidelines for Pulmonary Embolism (DOI: 10.1093/eurheartj/ehz405).

What are the limitations of the Pulmonary Embolism Risk Stratification (ESC/ERS 2019)?

Known limitations include: Wells score calculator not integrated; sPESI simplified; Does not address thrombolysis dosing. Individual patient factors may require deviation from these recommendations.

Get AI-Powered Analysis Alongside This Algorithm

In AttendMe.ai, the Pulmonary Embolism Risk Stratification (ESC/ERS 2019) appears automatically when your clinical question matches — alongside evidence from 3M+ peer-reviewed articles.

Try AttendMe Free