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Reviews in Cardiovascular Medicine  2011, Vol. 12 Issue (3): 157-163     DOI: 10.3909/ricm0584
Case Review Previous articles | Next articles
A Review of Electrocardiography in Pulmonary Embolism: Recognizing Pulmonary Embolus Masquerading as ST-Elevation Myocardial Infarction
Kanwal Pratap Singh Raghav1, Premraj Makkuni2, Vincent M. Figueredo3
1 Department of Hematology/Oncology, MD Anderson Cancer Center, Houston, TX
2 Department of Cardiology, Albert Einstein Medical Center, Philadelphia, PA
3 Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, and Jefferson Medical College, Philadelphia, PA
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Abstract:
A 64-year-old woman with hypertension and diabetes presented with acute shortness of breath and left-sided chest discomfort. Electrocardiogram (ECG) demonstrated Q waves, coved ST-segment elevations, and T-wave inversions in leads V1-V4, suggesting acute anterior ST-elevation myocardial infarction (STEMI). Catheterization revealed nonocclusive coronary artery disease with elevated pulmonary and right heart pressures, confirmed by echocardiography. Ventilation perfusion scan was deemed high probability for pulmonary embolism (PE). Treatment for a submassive PE was initiated and ECG changes resolved by discharge. This case exemplifies similarities in clinical presentation of PE and acute STEMI. The presence of Q waves in anterior leads with coved ST-elevation after PE has not been described previously. We review the differential diagnosis of ST elevation and the assorted spectrum of ECG changes seen in PE.
Key words:  Acute myocardial infarction      Electrocardiography      Pulmonary embolism      ST-segment elevation      McGinn-White sign     
Published:  30 September 2011     

Cite this article: 

Kanwal Pratap Singh Raghav, Premraj Makkuni, Vincent M. Figueredo. A Review of Electrocardiography in Pulmonary Embolism: Recognizing Pulmonary Embolus Masquerading as ST-Elevation Myocardial Infarction. Reviews in Cardiovascular Medicine, 2011, 12(3): 157-163.

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https://rcm.imrpress.com/EN/10.3909/ricm0584     OR     https://rcm.imrpress.com/EN/Y2011/V12/I3/157

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