EKG in Acute Pulmonary Embolism The sensitivity and specificity for EKG findings in acute PE are low. EKG is helpful in evaluating for other causes of cardio-pulmonary symptoms + supporting evidence of PE Increased Adrenergic Drive: • Sinus Tachycardia (most common finding) • Atrial Arrhythmia* (e.g., A-Fib also a result of atrial stretch) RA/RV Dilation: • Incomplete or Complete RBBB (RBB prone to stretch especially early in its course) • Right Axis Deviation • Dominant R Wave in V1 • Shift of Precordial Transition Point to V5 (as RV "rotates" with dilation in relation to ECG leads) RV Ischemia or Strain: • S1-Q3-T3 (not a sensitive finding) • TWI in Right Precordial Leads (VI-V3) +/- Inferior Leads • Non-specific ST-T Changes • STE in aVR +/- Right Precordial Leads - Karan Desai MD @karanpdesai via CardioNerds @cardionerds #EKG #EKG #Pulmonary #Embolism #AcutePE #diagnosis #cardiology #electrocardiogram
