The current European Society of Cardiology guidelines (ESC) on the management of patients with acute pulmonary embolism (PE) recommend a risk adapted management for therapy and discharge [1]. Doubtless the introduction of direct oral anticoagulants (DOACs) has further facilitated early discharge of PE patients at lower risk of short-term mortality [2,3]. However, the identification of these patients remains problematic in daily clinical practice. Electrocardiogram (ECG) represents the most commonly performed non-invasive cardiovascular diagnostic test in patients presenting with respiratory and/or cardiac symptoms, like those with suspected acute PE [4].