P-wave analysis in myocardial infarction, pulmonary edema, and embolism

In a retrospective study, the P-terminal force in Lead V1 (PTF-V1) was measured in three groups, each of 35 patients, with the respective diagnoses of acute myocardial infarction without pulmonary edema, acute pulmonary embolism, and acute pulmonary edema. In all but one of the patients with acute pulmonary edema, a highly negative PTF-V1 value was obtained, whereas by contrast, all the patients with pulmonary embolism had normal PTF-V1 values. Four of the patients with acute myocardial infarction had abnormal PTF-V1 values, although at the time there was no clinical or radiologic evidence of pulmonary edema. However, one of these patients did develop acute pulmonary edema a few hours later. Measurement of the PTF-V1 is a simple noninvasive test that may, therefore, be useful in separating patients with acute pulmonary embolism from those with acute or impending pulmonary edema.