How useful are ECG findings in diagnosing pulmonary embolism?

Rodger M, et al. Diagnostic value of the electrocardiogram in suspected pulmonary embolism. Am J Cardiol. 2000 Oct 1;86(7):807-9, A10.

Objective: To evaluate the prevalence of ECG changes in patients with suspected PE.

Conclusion: ECG is of limited value in diagnosing PE.

Methods: Prospective study of consecutive in-patients and out-patients suspected of having a PE and referred for ventilation perfusion scan or pulmonary angiogram. Participants included patients of age >18 years who could give consent; were able to receive a pulmonary angiogram; were not ventilated; and were not in the final stages of terminal disease. ECG was obtained within 24 hours of ventilation perfusion scan. Three investigators (including 2 cardiologists) independently assessed ECGs for 28 features. Two nuclear medicine physicians indepently assessed ventilation perfusion scans using PIOPED criteria.

Results: 49 patients had PE; 163 did not have a PE. Table 1 (p. 808) summarizes the event rates for various ECG findings, including S1Q3T3 (found in 11.6% of patients with PE and in 13.5% of patients without PE.)

How I found it: Searched PubMed for “electrocardiography AND pulmonary embolism AND sensitivity;” I found many recent articles about ECG findings in patients with PE, but not prospective studies of patients with suspected PE. Thus, this article was at the bottom of the results list because of its publication date.

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About Amy

Clinical Informationist at EUH Branch Library
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