S1Q3T3 Pattern: Pulmonary Embolism

Report:

Sinus tachycardia 152/min

Normal axis +70o

S1Q3T3 (McGinn-White) pattern of acute cor pulmonale

Comment:

This patient had the full hand: predisposing thrombophlebitis, left pleuritic chest pain, dyspnœa, shock, clear CXR, hypoxæmia on 15 L/min oxygen and the classical ECG shown. The lung scan showed 50% defect in the right lung and 30% in the left lung.

He improved rapidly on streptokinase infusion, with the “RV strain pattern” (T inversion V1-3) evolving, as expected, the next day (Fig 186a below).

186a. 187. 68 year old woman in coma

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