Sarin Sanjay, Elmi Farhad, Nassef Louis
Department of Internal Medicine, Geisinger Medical Center, Danville, PA 17822, USA.
J Electrocardiol. 2005 Oct;38(4):361-3. doi: 10.1016/j.jelectrocard.2005.05.008.
Electrocardiogram (ECG) is of limited diagnostic value in patients suspected with pulmonary embolism (PE). However, recent studies suggest that inverted T waves in the precordial leads are the most frequent ECG sign of massive PE (Chest 1997;11:537). Besides, this ECG sign was also associated with the best sensitivity, specificity, and positive and negative predictive values for diagnosing PE. We report 2 cases with similar ECG findings that were referred to us as unstable angina. Both were hemodynamically stable and had moderate-size pulmonary emboli. The ECG findings reverted to normal within a week of anticoagulation treatment. Our observation suggests that even a moderate-size PE can cause these ECG changes.
心电图（ECG）对疑似肺栓塞（PE）患者的诊断价值有限。然而，最近的研究表明，胸前导联T波倒置是大面积PE最常见的心电图表现（《胸部》1997年；11:537）。此外，这种心电图表现对诊断PE的敏感性、特异性以及阳性和阴性预测值也最佳。我们报告2例有类似心电图表现的病例，最初被诊断为不稳定型心绞痛转诊至我院。这2例患者血流动力学稳定，有中等大小的肺栓塞。抗凝治疗一周内心电图表现恢复正常。我们的观察表明，即使是中等大小的PE也可引起这些心电图改变。
