The recently published 2026 AHA/ACC guideline for the evaluation and management of acute pulmonary embolism (PE) introduces several conceptual innovations that may influence clinical practice beyond North America [1]. However, some aspects of the proposed framework warrant further discussion. One of the most notable innovations is the introduction of the AHA/ACC Acute PE Clinical Categories (A–E), which aim to integrate clinical severity scores, right ventricular imaging findings, cardiac biomarkers, and hemodynamic parameters.
