ECG Strip 20

 

ECG Strip 20 - pulmonary embolism
 

A patient (57 years old male) was sent by his general practitioner. He injured his Achilles tendon and has his right lower extremity immobilized. He regularly uses LMWH. The patient suffers from pain and swelling og the extremity. The problems last for few days and they are accompanied with shortness of breath. D-dimers are elevated. The ECG shows normal regular sinus rhythm with negative T waves in leads III and V1-V2. These ECG changes are together with personal history very suspicious of an acute pulmonary embolism. The patient is hospitalized; CT angiography confirms a massive bilateral pulmonary embolism.