EKG in PE

Case: 22F cc: chest pain, dyspnea
Dx: Pulmonary embolism

​EKG changes in PE:

• sinus tachycardia (44%)
• complete or incomplete RBBB (18%, and inc mortality)
• RAD (16%)
• dominant R wave in V1
• P pulmonale (95-peaked P in II >2.5)
• persistent S wave in V6
• RV strain pattern
• • STD and/or TWI in inferior and anterior leads (II, III, aVF, V1, V2, V3)
• S1Q3T3 (only in 20% of PE)

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