Acute pulmonary embolism is a common major medical condition and is frequently poorly managed. There has been wide variation within and between countries, and even within hospitals, on how to diagnose and treat this frequently encountered medical emergency. This review examines the current status and advances now available in most acute centres, and reveals how the new European Society of Cardiology guidelines simplify this complex and poorly understood condition. Particular emphasis is placed on the new role of biochemical markers of myocardial stress and on the definition of right ventricular dysfunction as key determinants of severity and risk of death and for specific therapy.
