التفاصيل البيبلوغرافية
| العنوان: |
ECG in suspected pulmonary embolism. |
| المؤلفون: |
Thomson, Duncan, Kourounis, Georgios, Trenear, Rebecca, Messow, Claudia-Martina, Hrobar, Petr, Mackay, Alistair, Isles, Chris |
| المصدر: |
Postgraduate Medical Journal; Jan2019, Vol. 95 Issue 1119, p12-17, 6p, 1 Diagram, 3 Charts, 2 Graphs |
| مصطلحات موضوعية: |
PULMONARY embolism, DIFFERENTIAL diagnosis, ELECTROCARDIOGRAPHY, RETROSPECTIVE studies, CASE-control method |
| مصطلحات جغرافية: |
SCOTLAND |
| مستخلص: |
Objective: To establish the diagnostic value of prespecified ECG changes in suspected pulmonary embolism (PE).Methods: Retrospective case-control study in a district general hospital setting. We identified 189 consecutive patients with suspected PE whose CT pulmonary angiogram (CTPA) was positive for a first PE and for whom an ECG taken at the time of presentation was available. We matched these for age±3 years with 189 controls with suspected PE whose CTPA was negative. We considered those with large (n=76) and small (n=113) clot load separately. We scored each ECG for the presence or absence of eight features that have been reported to occur more commonly in PE.Results: 20%-25% of patients with PE, including those with large clot load, had normal ECGs. The most common ECG abnormality in patients with PE was sinus tachycardia (28%). S1Q3T3 (3.7%), P pulmonale (0.5%) and right axis deviation (4.2%) were infrequent findings. Right bundle branch block (9.0%), atrial dysrhythmias (10.1%) and clockwise rotation (20.1%) occurred more frequently but were also common in controls. Right ventricular (RV) strain pattern was significantly more commonly in patients than controls, 11.1% vs 2.6% (sensitivity 11.1%, specificity 97.4%; OR 4.58, 95% CI 1.63 to 15.91; p=0.002), particularly in those with large clot load, 17.1% vs 2.6% (sensitivity 17.1%, specificity 97.4%; OR 7.55, 95% CI 1.62 to 71.58; p=0.005).Conclusion: An ECG showing RV strain in a breathless patient is highly suggestive of PE. Many of the other ECG changes that have been described in PE occur too infrequently to be of predictive value. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
