Acute pulmonary embolism
See brief interpretation of 12 lead EKG above
Acute pulmonary embolism is causing strain on the right chambers of the heart because of blockage of the main pulmonary artery or its branches.
Consequently the EKG may present with negative T waves in the right precordial leads as well as right bundle branch block. The limb leads may show S1Q3T3 pattern – that is a large S wave in lead I plus a large Q wave and an inverted T wave in lead III. Also the right atrium may show signs of dilation (tall p waves in II, p pulmonale). Atrial flutter or atrial fibrillation may occur.
Importantly all mentioned findings may be transient and the EKG may be normal or show only sinus tachycardia.
Pulmonary embolism should be suspected in patients with sudden shortness of breath, hemoptysis and chest pain.
– Mathias
