PMID- 20522055
OWN - NLM
STAT- MEDLINE
DCOM- 20101008
LR  - 20211020
IS  - 1542-474X (Electronic)
IS  - 1082-720X (Print)
IS  - 1082-720X (Linking)
VI  - 15
IP  - 2
DP  - 2010 Apr
TI  - Electrocardiographic differentiation between acute pulmonary embolism and non-ST 
      elevation acute coronary syndromes at the bedside.
PG  - 145-50
LID - 10.1111/j.1542-474X.2010.00355.x [doi]
AB  - BACKGROUND: Clinical picture of acute pulmonary embolism (APE), with wide range 
      of electrocardiographic (ECG) abnormalities can mimic acute coronary syndromes. 
      OBJECTIVES: Assessment of standard 12-lead ECG usefulness in differentiation at 
      the bedside between APE and non-ST elevation acute coronary syndrome (NSTE-ACS). 
      METHODS: Retrospective analysis of 143 patients: 98 consecutive patients (mean 
      age 63.4 +/- 19.4 year, 45 M) with APE and 45 consecutive patients (mean age 72.8 
      +/- 10.8 year, 44 M) with NSTE-ACS. Standard ECGs recorded on admission were 
      compared in separated groups. RESULTS: Right bundle branch block (RBBB) and 
      S(1)S(2)S(3) or S(1)Q(3)T(3) pattern were found in similar frequency in both 
      groups (10 [11%] APE patients vs 6 [14%] NSTE-ACS patients, 27 [28%] patients vs 
      7 [16%] patients, respectively, NS). Negative T waves in leads V(1-3) together 
      with negative T waves in inferior wall leads II, III, aVF (OR 1.3 [1.14-1.68]) 
      significantly indicated APE with a positive predictive value of 85% and 
      specificity of 87%. However, counterclockwise axis rotation (OR 4.57 
      [2.74-7.61]), ventricular premature beats (OR 2.60 [1.60-4.19]), ST depression in 
      leads V(1-3) (OR 2.25 [1.43-3.56]), and negative T waves in leads V(5-6) (OR 2.08 
      [1.31-3.29]) significantly predicted NSTE-ACS. CONCLUSIONS: RBBB, S(1)S(2)S(3), 
      or S(1)Q(3)T(3) pattern described as characteristic for APE were not helpful in 
      the differentiation between APE and NSTE-ACS in studied group. Coexistence of 
      negative T waves in precordial leads V(1-3) and inferior wall leads may suggest 
      APE diagnosis.
FAU - Jankowski, Krzysztof
AU  - Jankowski K
AD  - Department of Internal Medicine and Cardiology of Warsaw Medical University, 
      Poland.
FAU - Kostrubiec, Maciej
AU  - Kostrubiec M
FAU - Ozdowska, Patrycja
AU  - Ozdowska P
FAU - Milanowska-Puncewicz, Blanka
AU  - Milanowska-Puncewicz B
FAU - Pacho, Szymon
AU  - Pacho S
FAU - Pedowska-Wloszek, Justyna
AU  - Pedowska-Wloszek J
FAU - Kaczynska, Anna
AU  - Kaczynska A
FAU - Labyk, Andrzej
AU  - Labyk A
FAU - Hrynkiewicz, Anna
AU  - Hrynkiewicz A
FAU - Pruszczyk, Piotr
AU  - Pruszczyk P
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - United States
TA  - Ann Noninvasive Electrocardiol
JT  - Annals of noninvasive electrocardiology : the official journal of the 
      International Society for Holter and Noninvasive Electrocardiology, Inc
JID - 9607443
SB  - IM
MH  - Acute Disease
MH  - Aged
MH  - Analysis of Variance
MH  - Coronary Disease/*diagnosis
MH  - Diagnosis, Differential
MH  - Electrocardiography/*methods/statistics & numerical data
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - Point-of-Care Systems/*statistics & numerical data
MH  - Predictive Value of Tests
MH  - Pulmonary Embolism/*diagnosis
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
PMC - PMC6932174
EDAT- 2010/06/05 06:00
MHDA- 2010/10/12 06:00
PMCR- 2010/04/12
CRDT- 2010/06/05 06:00
PHST- 2010/06/05 06:00 [entrez]
PHST- 2010/06/05 06:00 [pubmed]
PHST- 2010/10/12 06:00 [medline]
PHST- 2010/04/12 00:00 [pmc-release]
AID - ANEC355 [pii]
AID - 10.1111/j.1542-474X.2010.00355.x [doi]
PST - ppublish
SO  - Ann Noninvasive Electrocardiol. 2010 Apr;15(2):145-50. doi: 
      10.1111/j.1542-474X.2010.00355.x.