Pulmonary Embolism: Global T Inversion
Report:
Atrial fibrillation with ventricular response 67/min
Right axis deviation +90o
S1Q3T3 (McGinn-White) pattern consistent with pulmonary embolism
Diffuse T wave inversion
Comment:
The T waves make the trace unusual; embolism tends to produce shallower inversion confined to anteroseptal leads. It is possible â even likely - that the patientâs collapse added a cerebral component to his repolarisation abnormalities. It is equally possible that the adrenaline surge was iatrogenic rather than cerebral in origin. The current inversion took 24 hours to develop: the admission ECG (Fig 149a below) showed more modest ST/T changes.
The embolism was proven by VQ scanning.
149a. There are embryonic R waves and a small ST elevation in V1, probably significant in retrospect. 150. 20 year old with history of surgery for tricuspid atresia
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