Abstract
Background: Pulmonary embolism (PE) is one of the three leading causes of cardiovascular mortality worldwide. In early 2026, the American Heart Association (AHA) and the American College of Cardiology (ACC), in collaboration with eight specialty societies, published the first comprehensive guideline dedicated exclusively to the evaluation and management of acute PE in adults. Main Content: The guideline introduces a novel clinical classification system (AHA/ACC Acute PE Clinical Categories A–E), updates diagnostic strategies based on pretest probability assessment and age-adjusted D-dimer thresholds, prioritizes direct oral anticoagulants (DOACs) for anticoagulation therapy, clarifies the role of advanced interventional therapies, and emphasizes post-acute care and long-term follow-up. Conclusions: The 2026 guideline represents a paradigm shift from traditional risk stratification toward a phenotype-based clinical approach, facilitating more individualized treatment strategies and expanding the focus on post-discharge care. Implementation in Vietnam will require adaptation to local healthcare resources and specialist care networks.