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Updated: May 2, 2026

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Electrocardiographic abnormalities in patients with acute pulmonary embolism complicated by cardiogenic shock
Piotr Kukla1, William F McIntyre2, Kamil Fijorek3
1Department of Cardiology, Specialistic Hospital, Gorlice, Poland.
Background:
Cardiogenic shock (CS) is a predictor of poor prognosis in patients with acute pulmonary embolism (APE).
Objectives:
The aim of this study was to compare electrocardiography (ECG) parameters in patients with APE presenting with or without CS.
Methods:
A 12-lead ECG was recorded on admission at a paper speed of 25 mm/s and 10 mm/mV amplification. All ECGs were examined by a single cardiologist who was blinded to all other clinical data. All ECG measurements were made manually.
Results:
Electrocardiographic data from 500 patients with APE were analyzed, including 92 patients with CS. The following ECG parameters were associated with CS: S1Q3T3 sign, (odds ratio [OR]: 2.85, P<.001), qR or QR morphology of QRS in lead V1, (OR: 3.63, P<.001), right bundle branch block (RBBB) (OR: 2.46, P=.004), QRS fragmentation in lead V1 (OR: 2.94, P=.002), low QRS voltage (OR: 3.21, P<.001), negative T waves in leads V2 to V4 (OR: 1.81, P=.011), ST-segment depression in leads V4 to V6 (OR: 3.28, P<.001), ST-segment elevation in lead III (OR: 4.2, P<.001), ST-segment elevation in lead V1 (OR: 6.78, P<.01), and ST-segment elevation in lead aVR (OR: 4.35, P<.01). The multivariate analysis showed that low QRS voltage, RBBB, and ST-segment elevation in lead V1 remained statistically significant predictors of CS.
Conclusions:
In patients with APE, low QRS voltage, RBBB, and ST-segment elevation in lead V1 were associated with CS.
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