Diagnostic utility of electrocardiogram for diagnosing pulmonary embolism

Brown, Gerard

doi:10.1136/emj.2005.029041

Cited by 15 publications

(4 citation statements)

References 4 publications

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“…Inverted T wave in precordial leads, S1Q3T3, and ST elevation in aVR were the most common ECG parameters in PE patients. These ndings were also previously remarked as the most common ECG abnormalities in PE patients (9,(13)(14)(15). Furthermore, the results of the current study showed that some changes in ECG, including RBBB, iRBBB, S1Q3T3 sign, ST elevation in leads V1 and III, QR wave in lead V1, and inverted T wave in precordial leads were signi cantly more frequent in the MACE group than the control group.…”

Section: Discussionsupporting

confidence: 87%

Predictive Value of Electrocardiogram for the Occurrence of Major Adverse Cardiac Events in Patients with Pulmonary Embolism

Salimi

Javanshir

Sadat-Ebrahimi

et al. 2021

Preprint

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Background Pulmonary embolism (PE) is one of the most prevalent cardiovascular diseases worldwide. A few studies have advocated the applicability of electrocardiogram (ECG) for the determination of prognosis of PE patients. Considering the low-cost and wide availability of ECG we aimed to investigate the association of selected ECG parameters with the occurrence of major adverse cardiac events (MACE) in PE patients. Methods In this study, 733 adult patients admitted with a definite diagnosis of acute PE were included from a registry of PE patients in a tertiary heart center. The patients’ clinical records were retrospectively reviewed, and demographic information, ECG abnormalities as well as the data on MACE (including hypotension, mechanical ventilation, Syncope, cardiogenic shock, or in-hospital mortality) were extracted. Results A total of 177 patients (24.1%) had MACE. Right bundle branch block (RBBB), incomplete RBBB, S1Q3T3, ST elevation in leads V1 or III, QR wave in lead V1, and inverted T wave in lead V1 to V4 were more frequently detected in the ECGs of patients who developed MACE (P values = 0.006, 0.030, 0.001, 0.001, 0.042, 0.001, and 0.001, respectively). The results of multivariate regression analysis demonstrated that ST-elevation in aVR (OR = 3.87, 95%CI = 2.32–6.44, P = 0.001) and S1Q3T3 (OR = 2.04, 95%CI = 1.22–3.43, P = 0.007) were independent predictors of MACE in PE patients. The sensitivities of ST elevation in the aVR lead and S1Q3T3 were 53.1% and 59.9%, and specificities were 79.7% and 68.1%, respectively. Conclusion Some ECG parameters including S1Q3T3 and ST elevation in aVR are independent predictors of MACE in patients with PE. Investigating these parameters in ECG can be helpful in the determination of the prognosis of PE patients.

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Section: Discussionsupporting

confidence: 87%

Predictive Value of Electrocardiogram for the Occurrence of Major Adverse Cardiac Events in Patients with Pulmonary Embolism

Salimi

Javanshir

Sadat-Ebrahimi

et al. 2021

Preprint

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“…Moreover, ECG changes depicting right ventricular strain are not sensitive to diagnose acute right‐sided heart failure . In general, ECG findings should not stand alone and diagnosis should be supported, if possible, by an acute echocardiogram as well as computed tomography pulmonary angiogram to diagnose acute right‐sided heart failure, help identifying the specific underlying cause and to guide treatment. In addition to treatment of the specific underlying cause, management of acute right‐sided heart failure due to pulmonary hypertension includes volume unloading, right ventricle afterload reduction, that is, decreasing pulmonary vascular tone by correcting hypercapnia, acidemia and alveolar hypoxia, and administration of vasoactive and inotropic drugs to achieve pulmonary vasodilation and improve right ventricle contractility.…”

Section: Discussionmentioning

confidence: 99%

Fatal right‐sided heart failure due to leukostasis in a patient with leukemic transformation of myelodysplastic syndrome

Pryds

Rasmussen

Andersen

2018

Clinical Case Reports

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“…ECG is an important test for the evaluation of diseases with similar presentation to that of PE in the acute phase and can be included in some risk-stratification strategies. 27 …”

Section: Discussionmentioning

confidence: 99%

Clinical profile, management and outcomes of patients with pulmonary embolism: a retrospective tertiary centre study in Angola

Manuel¹,

Aufico²,

Africano³

et al. 2017

CVJA

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SummaryObjective:Pulmonary embolism (PE) is a potentially fatal disease. In Angola, few data are available on its occurrence. The aim of the study was to characterise the clinical profile, management and outcomes of patients with PE.Methods:A retrospective observational study was conducted at the Girassol Clinic in Luanda, Angola. The medical records of patients admitted to the intensive care unit were analysed from 2011 to 2015.Results:Fifty patients were included and the median age was 50.5 ± 17.8 years. Dyspnoea and immobilisation for more than 72 hours were the most frequently seen risk factors at admission; 28% of the patients had massive PE, 36% sub-massive PE, 28% were haemodynamically unstable at admission and 30% had a very high risk of mortality. The in-hospital mortality rate was 20%.Conclusions:The clinical characteristics of our patients were similar to those described in the literature. The high prevalence of patients with very high risk at admisson highlights the need to investigate the cause of worst cardiovascular disease outcomes in Africans.

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Diagnostic utility of electrocardiogram for diagnosing pulmonary embolism

Cited by 15 publications

References 4 publications

Predictive Value of Electrocardiogram for the Occurrence of Major Adverse Cardiac Events in Patients with Pulmonary Embolism

Predictive Value of Electrocardiogram for the Occurrence of Major Adverse Cardiac Events in Patients with Pulmonary Embolism

Fatal right‐sided heart failure due to leukostasis in a patient with leukemic transformation of myelodysplastic syndrome

Clinical profile, management and outcomes of patients with pulmonary embolism: a retrospective tertiary centre study in Angola

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