A 30-something with Chest pain and SOB

In conclusion, the presence of negative T waves in both leads III and V1 allows PE to be differentiated simply but accurately from ACS in patients with negative T waves in the precordial leads. "See this post for more detail on the ECG in pulmonary embolism. Still more cases are here.==================================My Comment by KEN GRAUER, MD (1/19/2023):==================================How good is the ECG for the diagnosis of acute PE? The answer is — it depends! Sometimes the ECG is excellent, in that it immediately tells you " high probability for massive acute PE ". At other times — the initial ECG may be suggestive enough to mandate immediate further testing (ie, bedside Echo; chest CT) — albeit not by itself diagnostic. And then there are times when the ECG disappointingly neither rules in nor out a meaningful acute PE.I completely agree with Dr. Smith in that today ' sinitial ECG is saying, " Treat me as an acute PE until you can prove otherwise! " That said — for discussion purposes, I wanted to focus on a few additional points regarding today ' s case. For clarity in Figure-1  — I ' ve reproduced and labeled several beats from the initial ECG.Figure-1: The initial ECG in today ' s case. I ' ve labeled the 5 beats that are seen in simultaneously-recorded leads V1,V2,V3 — as well as the S1Q3T3 (See text).How Is the Diagnosis ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs