T-wave inversion in patients with acute pulmonary embolism: prognostic value

Heart Lung. 2015 Jan-Feb;44(1):68-71. doi: 10.1016/j.hrtlng.2014.10.003. Epub 2014 Nov 14.

Abstract

Introduction: T-wave inversion (TWI) is a common ECG finding in patients with acute pulmonary embolism (APE).

Objectives: To determine the prevalence of TWI in patients with APE and to describe their relationship to outcomes.

Methods: Retrospective study of 437 patients with APE. TWI patterns were described in two distributions: inferior (II, III, aVF) and precordial (V1-V6).

Results: TWI was observed in 258 (59%) patients. The mortality rate was significantly higher in the group with TWI in the inferior AND precordial leads compared to the group without TWI (OR: 2.74; p = 0.024) and the group with TWI in the inferior OR precordial leads (OR: 2.43; p = 0.035). As compared those with TWI in <5 leads, patients with TWI in ≥5 leads experienced significantly higher rates of death (17.1% vs. 6.6%, OR: 2.92; p = 0.002) and complications.

Conclusions: TWI and the quantitative assessment thereof can be useful to risk stratify patients with APE.

Keywords: Acute pulmonary embolism; ECG; Emergency medicine; Prognosis; Risk stratification.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arrhythmias, Cardiac / diagnosis*
  • Arrhythmias, Cardiac / etiology
  • Brugada Syndrome
  • Cardiac Conduction System Disease
  • Electrocardiography*
  • Female
  • Heart Conduction System / abnormalities*
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Pulmonary Embolism / complications
  • Pulmonary Embolism / diagnosis*
  • Pulmonary Embolism / physiopathology
  • Retrospective Studies