Pulmonary Embolism

In case of a pulmonary embolism several clinical features may be present:[1]

• Sinus Tachycardia
• Stress on the right ventricle:
  • right atrial dilatation
  • Heartaxis is to the right
  • Right bundle branch block (RBBB)

"S1Q3T3"

• Deep S in I
• Q and negative T in III
• T wave inversion anterior [2]

Pulmonary embolism cannot solely be diagnosed using an ECG, but it may be helpful.

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  ECG of a patiënt with pulmonary embolism

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  Another example of an ECG of a patiënt with pulmonary embolism. Note the tachycardia and right axis.

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  An example of right ventricular hypertrophy (and right atrial enlargement) in a patient with chronic pulmonary hypertension due to peripheral embolisation.

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  A 12 lead ECG of a patient with pulmonary embolism

References

1. Rodger M, Makropoulos D, Turek M, Quevillon J, Raymond F, Rasuli P, and Wells PS. Diagnostic value of the electrocardiogram in suspected pulmonary embolism. Am J Cardiol. 2000 Oct 1;86(7):807-9, A10. DOI:10.1016/s0002-9149(00)01090-0 |