Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology
-
Acute pulmonary embolism (PE) is a common clinical entity in the emergency department, and remains a diagnostic challenge for physicians. The role of the 12-lead electrocardiogram (ECG) in its diagnosis and assessment of severity and prognosis is not as well defined as for acute coronary syndromes. We report four cases of massive and submassive PE with differing ECG findings admitted to an acute cardiac care unit. We review the role of different ECG abnormalities and also discuss the relevance of transthoracic echocardiographic data in the diagnosis and serial evaluation of patients with PE. Treatment options for PE with hemodynamic compromise and right ventricular dysfunction are also discussed. ⋯ ECG findings have low sensitivity and specificity in the diagnosis of PE. It should be routinely used in serial evaluations, particularly when hemodynamic compromise is present, and should be included in the range of diagnostic strategies available.