,Clinical and electrocardiographic characteristics of acute pulmonary embolism with ST elevation in

• 作 者: ZHAN Zhong-qun YI Yuan Kjell C.Nikus Andrés Ricardo Pérez-Riera
• 机 构: Department of Cardiology, Shenzhen Guangming Central Hospital, Shenzhen 518107, Guangdong Province,C
• 出 处: 岭南心血管病杂志（英文版）
• 发表日期: 2017年2期
• 关键词: acute pulmonary embolism ECG ST-segment elevation myocardial infarction

Background ST-segment elevation (STE) in the right precordial leads is an ECG manifestation of acute pulmonary embolism (APE) and some patients present with concomitant STE in the inferior leads.This clinical entity apparently deserves careful attention.Methods We included 42 APE patients presenting with ≥ 0.1 mV STE in leads V1-V3/V4.Clinical and ECG characteristics in 15 patients with and 27 without STE in the inferior leads were included for comparison.Results Of the 42 patients,98％ were classified as high or intermediate risk patients,79％ showed ECG signs of right ventricular strain (RVS) and 83％ showed the maximal amplitude of STE in leads V1-V2.The patients with STE in the inferior leads presented with faster heart rate (131±30 vs.108±21 beats/min,P=0.015),lower systolic blood pressure (107±22 vs.123±26 mmHg,P=0.043),higher incidence of elevated troponin (87％ vs.56％,P=0.040) and need to intensify therapy (73％ vs.33％,P=0.013).Conclusions STE in the right precordial leads is an ECG manifestation of intermediate to high risk in APE patients.The ECG characteristics include the maximal amplitude of STE in leads V1-V2 and the RVS patte.Simultaneous STE in the inferior and right precordial leads is associated with hemodynamic instability and need for intensified therapy.