Diagnostic value of the electrocardiogram in suspected pulmonary embolism

A variety of electrocardiographic (ECG) changes have been suggested to have diagnostic value in patients with suspected pulmonary embolism (PE).(1-5) However, most of these investigations have only studied patients with confi rmed PE, Few investigators have reported on the prevalence of ECG changes i n patients with suspected PE. The diagnostic value of a test can only be de termined by applying the test to patients with suspected disease and then d etermining if the test is predictive of outcome. Further, previous investig ations examining the diagnostic value of the electrocardiogram in suspected PE have been limited by patient selection (critical care patients only)(6, 7) or by not comparing the diagnostic value of the electrocardiogram with a n appropriate reference standard (perfusion scans only).(7).