著者
Masami Kosuge Toshiaki Ebina Kiyoshi Hibi Kengo Tsukahara Noriaki Iwahashi Satoshi Umemura Kazuo Kimura
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-13-1064, (Released:2013-12-03)
参考文献数
24
被引用文献数
3 7

Background: Patients with acute pulmonary embolism (APE) often have negative T waves (Neg T) in precordial leads at presentation, but this is also found in acute coronary syndrome (ACS) caused by left anterior descending coronary artery (LAD) disease. Methods and Results: Differences in Neg T on admission electrocardiograms were studied between 107 patients with APE and 248 patients with ACS caused by LAD disease. All patients had Neg T in leads V1–4 and were admitted within 7 days from symptom onset. The number of leads with Neg T (4.8±1.8 vs. 5.5±1.7, P<0.001) and maximum magnitude of Neg T (3.4±2.0 vs. 4.7±3.3mm, P<0.001) were lower in APE. The frequency of occurrence of Neg T in each of the 12 leads, and the precordial lead with the greatest Neg T (peak Neg T) differed between APE and ACS (all P<0.05, respectively). APE was strongly associated with the presence of Neg T in both leads III and V1 and peak Neg T in leads V1–2. The combination of these 2 findings identified APE with 98% sensitivity, 92% specificity, and 94% predictive accuracy, which represented the highest diagnostic accuracy. Conclusions: Among patients with APE and ACS who have precordial Neg T, the presence of Neg T in leads III and V1 and/or peak Neg T in leads V1–2 simply but accurately differentiates APE from ACS.

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Twitter (2 users, 2 posts, 1 favorites)

@thebyrdlab Not my favourite or anything, but I've only stumbled upon it a couple of weeks ago, so I'm sharing it e… https://t.co/uk1Rbx0NRh
T wave inversion in V1-V4, and inferior leads, highly suspicious for PE. https://t.co/dVDQnpqkF9

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