Pulmonary Embolism: Global T Inversion

Report:

Atrial fibrillation with ventricular response 67/min

Right axis deviation +90o

S1Q3T3 (McGinn-White) pattern consistent with pulmonary embolism

Diffuse T wave inversion

Comment:

The T waves make the trace unusual; embolism tends to produce shallower inversion confined to anteroseptal leads. It is possible – even likely - that the patient’s collapse added a cerebral component to his repolarisation abnormalities. It is equally possible that the adrenaline surge was iatrogenic rather than cerebral in origin. The current inversion took 24 hours to develop: the admission ECG (Fig 149a below) showed more modest ST/T changes.

The embolism was proven by VQ scanning.

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