New American College of Cardiology/American Heart Association guidelines introduce a five-stage disease classification system for acute pulmonary embolism (PE).[1] The older classification of PE according to the extent of obstruction divided the disease into small (<25%), submassive (25–50%), massive (51–65%) and fulminant (>66%).[1] The 2008 ESC guidelines replaced this terminology with a classification according to the risk of early mortality: high, moderate, and low risk.[1][2] Current terminology further divides non-high-risk PE into intermediate and low-risk based on biomarkers of myocardial damage or right ventricular dysfunction.[2] Risk stratification is complemented by the PESI prognostic model or its simplified version sPESI.[2] In patients with intermediate higher risk, immediate thrombolysis is not indicated, but intravenous heparin with monitoring for 48–72 hours.[2] The article also mentions the heart xenograft consensus and new VTE biomarkers.[1]