Acute Non-Embolic Cor Pulmonale

Report:

Sinus tachycardia 130/min

Normal axis

S1Q3T3 (McGinn-White) pattern consistent with acute cor pulmonale

RSR’ pattern V1

Precordial T wave inversion consistent with right ventricular strain

Comment:

The combined features are strongly suggestive of acute cor pulmonale.

In the context of pulmonary œdema (ARDS) in the single lung, the eponymous pattern did not add to the diagnosis of obvious and expected pulmonary hypertension. Yet, such is the power of words (S1Q3T3 pattern), that some members of the staff proposed “ruling out” pulmonary embolism on the strength of the S1Q3T3 pattern they knew to be associated with it!

I have never seen (or know anyone who has) a white lung due to pulmonary embolism. The contralateral one, perhaps (v. Case 203)! This patient of course did not have a contralateral lung.

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