Pulmonary embolism

Pulmonary embolism causes ECG signs of acute pulmonary hypertension or right ventricular strain. It most commonly causes a sinus tachycardia. Other changes include RBBB (complete or incomplete), right axis deviation, R in V1, right atrial enlargement, S1Q3T3, clockwise rotation, atrial arrhythmias and nonspecific ST-T changes.

See also: Pulmonary and Pericardial

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References

  • Hampton J, Hampton J. The ECG Made Easy. 9th edition. Elsevier

ECG Library (14)

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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 S1Q3T3 ST elevation in aVR Regular Sinus tachycardia 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: - Dizziness Dyspnoea Syncope 12-Lead Right Axis Deviation RSR' Tachycardia Wide complex tachycardia Wide QRS RBBB Pulmonary embolism Dr Smith's ECG Blog CC BY-NC
RBBB. Is there ST Elevation in III and aVR, with reciprocal ST depression in I and aVL?

This ECG is from a man of unknown age who presented with dizziness and dyspnoea on a background of stage 4 lymphoma. He was tachycardic, tachypnoeic (31) and hypoxic (SpO2 79%). The lungs were clear on auscultation.

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