Pulmonary Embolism

Pulmonary EmbolismCreated OnApril 19, 2020Last Updated OnApril 19, 2020byadmin You are here: Main ECG Pulmonary Embolism < All Topics Table of Contents A differentials of tall R-wave in V1 ECG findings in Pulmonary Embolism Sinus Tachycardia (only in 30-50%) SIQIII or SIQIIITIII, a.k.a. Rightward Axis (not sensitive or specific) New RBBB or incomplete RBBB ST-segment elevations or depressions New TWI’s, especially in anteroseptal(V1-V4) +/- inferior leads(II,III,aVF) = Acute Pulmonary Hypertension = PE until proven otherwise! Atrial and ventricular dysrhythmias, Supraventricular tachydysrhythmias Signs of right heart strain Rightward axis (look for large S wave in lead I) New RBBB or incomplete RBBB New T-wave inversions (especially in anteroseptal +/- inferior leads) ST-segment elevations or depressions ST-elevation in rightward leads (V1, V2, aVR, III) Take-home points: You can’t rule out PE based on a normal HR (or normal ECG)! Massive pulmonary embolism can mimic acute coronary syndrome and cause ST-segment elevations in rightward leads PE commonly mimics ACS (especially big pes) Expect T-wave inversions and ST-segment changes STE in V1-V2& aVR Make sure to consider PE in cases of acute onset chest pain and pay close attention to new TWI’s, ST-segment changes, or ventricular dysrhythmias. Consider your ECG Differentials! Rightward axis is not typical for STEMI Consider PE & Hyperkalaemia when dealing with STE & RAD PE’s can also cause low-grade fever, don’t be fooled in just calling it a pneumonia! Tachycardia (sinus, atrial fibrillation) Signs of right heart strain (RAD, tall R wave in V1) *We do not own this youtube video, it’s for sharing purpose

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