Electrocardiographic differentiation between acute coronary syndrome and acute pulmonary embolism associated with inverted T waves in precordial leads

摘要

Background Inverted T waves in precordial leads are often seen in patients with acute pulmonary embolism （APE） and acute coronary syndrome （ACS）. The purpose of this study was to analyze the electrocardiogram （ECG） difference between APE and ACS related inverted T waves in precordial leads. Methods The ECG difference among 62 patients with APE and 125 patients with ACS related inverted T waves in precordial leads were compared. Results Compared with ACS, Patients with APE were more frequently associated with incomplete or complete RBBB or slurred S wave in lead V1, the sum of the depth of inverted T waves in leads V1 and V2 not less than in lead V3 and V4 （inverted TV1 ＋ V2 ≥ inverted TV3 ＋ V4）, and inverted T waves in leads V1 and Ⅲ. Conclusions Complete or incomplete RBBB or slurred S wave in lead V1, inverted T waves in leads V1 and III, and inverted TV1 ＋ V2 ≥ inverted TV3 ＋ V4 are useful criteria for predicting APE.