Acute Cor Pulmonale

Report:

Sinus tachycardia 113/min

S1Q3T3 (McGinn-White) pattern

Incomplete right bundle branch block

Right precordial T wave inversion & ST segment depression

Consistent with acute cor pulmonale

Comment:

The classical S1Q3T3 (McGinn-White) pattern of submassive pulmonary embolism may represent a forme fruste of left posterior hemiblock69; to tell the truth, its genesis is far from understood (by me, at least). Similarly, the right precordial T wave inversion, while certainly a marker of extensive embolism70, does not have a clear-cut explanation. I once tried to relate it to the coexisting or preceding LPHB71, but now I think it’s weak.

The patient’s only risk factor was a trip to Canada and back to Australia.

101. 48 year old lady found unconscious at home, unrousable since admission

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