Pulmonary Embolism: Discrete S1Q3T3 Pattern

Report:

Sinus tachycardia 111/min

Borderline trace, probably normal

Comment:

Much depends what one is looking for. I countersigned the Registrar’s and the computer report of “otherwise normal ECG” during routine reporting, but the patient arrived to my ICU with CT angiogram showing 50% embolisation of her pulmonary arterial tree.

At least the next day’s tracing (Fig 68a below) did not surprise me. Typically, the S1 had gone, and the rate slowed to 84/min, but anteroseptal T wave inversion – a sign of a large embolus – developed.

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