In this episode, Dr Swapnil Pawar and Dr Madhuri Anupindi work through a case-based viva on acute pulmonary embolism: a 40-year-old with a CTPA-proven saddle PE after a long-haul flight.

We cover:
– Risk stratification using the 2019 ESC guidelines: sPESI, haemodynamic criteria, and the imaging and biomarker evidence of RV strain
– The brand-new 2026 AHA/ACC guidelines and their A–E classification, including respiratory modifiers and SCAI shock stages
– Advantages and disadvantages of the new AHA/ACC framework versus the ESC approach — a likely compare-and-contrast question for the upcoming Fellowship exam
– Management of intermediate–high risk PE: anticoagulation (and why LMWH beats a heparin infusion), full-dose vs reduced-dose systemic thrombolysis (PEITHO, MOPETT), catheter-directed thrombolysis (HI-PEITHO), suction and surgical embolectomy, RV support strategies, and the role of the PERT team

Detailed tables comparing the ESC and AHA/ACC classifications, plus the sPESI criteria, are in the show notes at critcareedu.com.au.

Want to go deeper on the new guidelines? We break them down in full on the latest episode of the eCritCare Podcast.

In this episode, we discuss the management of a 75-year-old patient who develops bloody diarrhoea on day two following endovascular aneurysm repair (EVAR) for a ruptured abdominal aortic aneurysm. We cover the differential diagnosis, the mechanisms of ischaemic colitis in this setting, the investigations used to evaluate it, and the principles of operative and non-operative management.

In this episode, we discuss the management of a 72-year-old patient presenting with massive upper GI bleeding from an aortoenteric fistula following endovascular AAA repair. We cover the differential diagnosis, immediate resuscitation priorities, and the post-operative management of acute kidney injury, including the evidence base for early versus delayed renal replacement therapy.