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Around 18% of patients with PE will have a completely normal ECG. However, with a compatible clinical picture (sudden onset pleuritic chest pain, hypoxia), an ECG showing new RAD, RBBB or T-wave inversions may raise the suspicion of PE and prompt further diagnostic testing
Discover ECG signs of pulmonary embolism, including right axis deviation and clockwise heart rotation.
Although the electrocardiogram in pulmonary embolism is not a test with high sensitivity or specificity, we can find EKG changes to support the diagnosis of PE. The main symptoms of pulmonary embolism are dyspnea, usually begin suddenly, and pleuritic chest pain.
Summary: This infographic explores the EKG findings associated with acute pulmonary embolism (PE). While EKG is not a diagnostic tool for PE due to low sensitivity and specificity, it can offer supporting evidence and aid in evaluating other causes of cardiopulmonary symptoms.
In this article, we describe the ECG presentations of two patients diagnosed with PE, and review the literature on the various types of ECG presentations and their role in predicting the prognosis of PE.
This is very common and is often the first clue that the patient may have a PE. The heart rate is often not responsive to fluids, and is a reaction of the body to compensate for the decreased ability for gas exchange.
ECG of a person with pulmonary embolism, showing sinus tachycardia of approximately 100 beats per minute, large S wave in Lead I, moderate Q wave in Lead III, inverted T wave in Lead III, and inverted T waves in leads V1 and V3.
The current data demonstrate that one-third of patients with PE will have an abnormal ECG pattern and are more likely to have RV dysfunction, but the utility of ECG as a point-of-care surrogate for an individual patient remains limited.
Although ECG findings in PE lack sensitivity and specificity, they remain clinically valuable when interpreted in the context of chest pain, dyspnea, hypoxia, syncope, or hemodynamic instability.
Our approach to risk stratification and management of (sub)massive PE tends to be dominated by CT scan and echocardiography (eye-candy modalities). And these are great. But I think there are situations where ECG can be really helpful – and it tends to get overlooked.