PDF(Pubmed)
Abstract：
Acute pulmonary embolism (PE) is potentially a life threatening emergency that needs prompt management to reduce preventable deaths. Symptoms like dyspnoea and chest discomfort often lack specificity and overlap with acute coronary syndrome (ACS). Importantly, electrocardiographic changes associated with PE are reported to be variable with some ECG patterns mimicking ACS, posing problems in the differential diagnosis. More recently, precordial T wave inversion has been described to be a clue to suggest PE. However, this ECG change is more likely to present in ACS. We herein reported a case of a 78-year-old man presenting with progressive shortness of breath on exertion secondary to submassive pulmonary embolism which was initially misdiagnosed as ACS due to diffuse T wave inversion in both precordial leads V1-6 and inferior Leads II, III and aVF. Here, we discussed the diagnosis of this case and reviewed the medical literature with an emphasis on the limitations of ECG for the differentiation between PE and ACS.
摘要：
急性肺栓塞（PE）可能是威胁生命的紧急情况，需要及时管理以减少可预防的死亡。呼吸困难和胸部不适等症状通常缺乏特异性，并与急性冠状动脉综合征（ACS）重叠。重要的是,据报道，与PE相关的心电图变化与某些模拟ACS的ECG模式不同。在鉴别诊断中存在问题。最近,心前区T波反转已被描述为提示PE的线索。然而,这种ECG变化更可能出现在ACS中.我们在此报告了一例78岁的男子，在继发于次大面积肺栓塞的劳力时出现进行性呼吸急促，最初由于心前导联V1-6和下导联II的弥漫性T波倒置而被误诊为ACS。III和aVF。这里,我们讨论了该病例的诊断,并回顾了医学文献,重点讨论了ECG在区分PE和ACS方面的局限性.
