Acute right heart strain

Acute right heart strain causes ST-T changes in V1-3 (sometimes V4) and inferior leads (II, III and aVF).

See also: Pulmonary and Pericardial

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In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea 12-Lead Inverted T waves Normal Sinus Rhythm Premature atrial complex Acute right heart strain Pulmonary embolism Dr Smith's ECG Blog CC BY-NC
An elderly woman transferred to you for chest pain, shortness of breath, and positive troponin – does she need the cath lab now?

This ECG is from an elderly woman who presented with sudden onset shortness of breath after months of inactivity due to a back injury.

This ECG shows sinus tachycardia with large inverted T waves, consistent with right heart strain. The cause was a very large PE.

In the ECGquest archives, this ECG has been tagged with: - Loss of consciousness 12-Lead Inverted T waves Normal Axis Regular S1Q3T3 ST elevation in aVR Tachycardia Sinus tachycardia Acute right heart strain Pulmonary embolism Dr Smith's ECG Blog CC BY-NC
Comatose after opiate overdose, with tachycardia and hypotension
In the ECGquest archives, this ECG has been tagged with: - 12-Lead Inverted T waves S1Q3T3 Acute right heart strain Pulmonary embolism Dr Smith's ECG Blog CC BY-NC
A crashing patient with an abnormal ECG that you must recognize