• Rev Cardiovasc Med · Jan 2011

    Review Case Reports

    A review of electrocardiography in pulmonary embolism: recognizing pulmonary embolus masquerading as ST-elevation myocardial infarction.

    • Kanwal Pratap Singh Raghav, Premraj Makkuni, and Vincent M Figueredo.
    • Department of Hematology/Oncology, MD Anderson Cancer Center, Houston, TX, USA.
    • Rev Cardiovasc Med. 2011 Jan 1;12(3):157-63.

    AbstractA 64-year-old woman with hypertension and diabetes presented with acute shortness of breath and left-sides chest discomfort. Electrocardiopgram (ECG) demonstrated Q waves, coved ST-segment elevations, and T-wave inversions in leads V₁-V₄, suggesting acute anterior ST-elevation myocardial infarction (STEMI). catheterization revealed nonocclusive coronary artery disease with elevated pulmonary and right heart pressures, confirmed by echocardiography. Ventilation perfusion scan was deemed high probability for pulmonary embolism (PE). Treatment for a submassive PE was initiated and ECG changes resolved by discharge. This case exemplifies similarities in clinical presentation of PE and acute STEMI. The presence of Q waves in anterior leads wih coved ST-elevation after PE has not been described previously. We review the differential diagnosis of ST elevation and the assorted spectrum of ECG changes seen in PE.

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