• Anna Kaczyńska, Anna Bochowicz, Maciej Kostrubiec, Marcin Szulc, and Piotr Pruszczyk.
• Klinika Chorób Wewnetrznych i Nadciśnienia Tetniczego AM w Warszawie.
• Pol. Arch. Med. Wewn. 2004 Sep 1; 112 (3): 1039-46.

UnlabelledAcute pulmonary embolism (APE) may lead to myocardial necrosis detected by elevation of cardiac troponin levels. We tried to assess, if electrocardiographic abnormalities may help to define APE patients with myocardial damage and at high risk of complicated clinical course. Therefore we analyzed 50 patients (34F) aged 64.6 +/- 16.9 with confirmed APE. On admission 12-lead standard ECG was recorded and cardiac troponin T (cTnT) was determined quantitatively (Roche). Serum cTnT levels > 0.01 ng/ml, regarded to indicate myocardial injury, were detected in 29 (58%) patients. ST segment depression in ECG was found in 24% of all patients and was more frequent in cTnT + then in group without myocardial injury (41.4% vs 0%, p=0.004). Complicated clinical course and death in acute pulmonary embolism were also more frequently observed in group with ST segment depression (47.1% vs 12.1%, p = 0.03 and 75.0% vs 14.3%, p = 0.02 respectively). Although negative T waves were slightly more frequent in patients with elevated serum troponin T level (65.5% vs 42.9%) and in patients, who died of pulmonary embolism (62.5% vs 54.8%), the difference did not reach statistical significance.ConclusionST segment depression detected in standard ECG in patients with APE suggests myocardial injury and may indicate unfavourable clinical course.

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