Role of the 12-lead electrocardiogram in diagnosing pulmonary embolism

Neeraj Sinha, Kiran Yalamanchili, Rishi Sukhija, Wilbert S. Aronow, Arlen G. Fleisher, George P. Maguire, Stuart G. Lehrman

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

We investigated the role of the standard 12-lead electrocardiogram (ECG) to improve the pretest probability of pulmonary embolism before performing computed tomographic (CT) pulmonary angiography. A retrospective chart analysis was performed on patients who underwent CT pulmonary angiography at a tertiary care hospital during a 30-month period. Comparison of 15 ECG parameters was made between those with CT pulmonary angiograms positive for pulmonary embolism and a matched control group with negative CT pulmonary angiograms. Data were analyzed by chi-squared tests and logistic regression. Sinus tachycardia (39% vs. 24%, P <0.01), an S1 Q3 T3 pattern (12% vs. 3%, P <0.01), atrial tachyarrhythmias (15% vs. 4%, P <0.005), a Q wave in lead III (40% vs. 26%, P <0.02), and a Q3 T3 pattern (8% vs. 1%, P <0.02) were the findings significantly associated with pulmonary embolism. We conclude that 1) standard 12-lead ECG findings can increase the pretest probability of pulmonary embolism before performing CT pulmonary angiography; and that 2) the ECG findings have relatively low likelihood ratios to have clinical use.

Original languageEnglish (US)
Pages (from-to)46-49
Number of pages4
JournalCardiology in review
Volume13
Issue number1
DOIs
StatePublished - Jan 1 2005

Keywords

  • Electrocardiogram
  • Pulmonary angiography
  • Pulmonary embolism

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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