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Related Experiment Videos

Right-sided EKG in pulmonary embolism.

Ravi Akula1, Syed P Hasan, Mohammad Alhassen

  • 1Division of Cardiology, Howard University Hospital, Washington, DC, USA.

Journal of the National Medical Association
|August 26, 2003
PubMed
Summary

Right-sided electrocardiogram (EKG) abnormalities are common in acute pulmonary embolism, particularly in patients without typical left-sided EKG changes. These findings help diagnose pulmonary embolism, especially when standard EKGs are normal.

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Area of Science:

  • Cardiology
  • Diagnostic Imaging

Background:

  • Acute pulmonary embolism (PE) is a life-threatening condition often diagnosed using imaging techniques.
  • Electrocardiography (EKG) is a readily available tool, but its utility in diagnosing PE, especially with subtle findings, requires further investigation.

Purpose of the Study:

  • To identify specific electrocardiogram (EKG) abnormalities in right-sided chest leads associated with acute pulmonary embolism (PE).
  • To evaluate the diagnostic value of right-sided EKGs in patients with suspected PE, particularly when standard 12-lead EKGs are inconclusive.

Main Methods:

  • Analysis of standard 12-lead and right-sided EKGs from 100 patients suspected of having pulmonary embolism.
  • Comparison of EKG parameters between right- and left-sided leads, focusing on changes indicative of right ventricular strain.

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  • Correlation of EKG findings with confirmed pulmonary embolism diagnoses.

    • Main Results:

    • Electrocardiogram (EKG) changes suggestive of acute right ventricular strain were observed in 80% of patients diagnosed with pulmonary embolism, appearing in both right- and left-sided leads.
    • Right-sided EKGs revealed ST segment elevation and qr/qs patterns in leads V4R, V5R, and V6R in four patients with pulmonary embolism who had normal left-sided EKGs.
    • These specific EKG changes indicative of right ventricular strain resolved within 24 hours in most patients.

    Conclusions:

    • Electrocardiogram (EKG) abnormalities in right-sided chest leads frequently occur in acute pulmonary embolism.
    • Routinely recorded right-sided EKGs demonstrate significant diagnostic potential, especially in pulmonary embolism cases lacking typical changes on standard 12-lead EKGs.
    • Findings support previous case reports on the utility of right-sided leads in diagnosing pulmonary embolism.