Electrocardiographic manifestations of pulmonary embolism

The electrocardiogram (ECG) may be entirely normal in the patient with pulm onary embolism (PE); alternatively, any number of rhythm and/or morphologic abnormalities may be observed in such a patient. The abnormal ECG may devi ate from the norm with alterations in rhythm, in conduction, in axis of the QRS complex, and in the morphology of the P wave, QRS complex, and ST segm ent/T wave. The electrocardiographic findings associated with PE are numero us, including arrhythmias (sinus tachycardia, atrial flutter, atrial fibril lation, atrial tachycardia, and atrial premature contractions), nonspecific ST segment/T wave changes, T wave inversions in the right precordial leads , rightward QRS complex axis shift and other axis changes, S1Q3 or S1Q3T3 p attern, right bundle branch block, and acute cor pulomnale. This review foc uses on the ECG and the various abnormalities seen in the patient with PE. Copyright (C) 2001 by W.B. Saunders Company.