HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (15) Citing Articles via Google Scholar Google Scholar Articles by Geibel, A. Articles by Konstantinides, S. V. Search for Related Content PubMed PubMed Citation Articles by Geibel, A. Articles by Konstantinides, S. V.

Prognostic value of the ECG on admission in patients with acute major pulmonary embolism

¹ Dept of Cardiology and Angiology, Albert Ludwigs University of Freiburg, and ³ Institute for Medical Biometry and Statistics, University of Freiburg, Freiburg, and ² Dept of Internal Medicine, St. Josefs Hospital, Wiesbaden, and ⁴ Dept of Cardiology and Pulmonary Medicine, Georg August University of Goettingen, Goettingen, Germany

CORRESPONDENCE: S. V. Konstantinides, Georg August University of Goettingen, Dept of Cardiology and Pulmonary Medicine, Robert Koch Strasse 40, Goettingen D-37085, Germany. Fax: 49 5513914131. E-mail: skonstan@med.uni-goettingen.de

Keywords: Mortality, prognosis, pulmonary arterial hypertension, pulmonary embolism, pulmonary embolism diagnosis

Received: October 20, 2004
Accepted January 6, 2005

A number of ECG abnormalities can be observed in the acute phase of pulmonary embolism (PE). Their prognostic value has not yet been systematically studied in large patient populations.

In 508 patients with acute major PE derived from a large prospective registry, the current authors assessed, on admission, the impact of specific pathological ECG findings on early (30-day) mortality.

Atrial arrhythmias, complete right bundle branch block, peripheral low voltage, pseudoinfarction pattern (Q waves) in leads III and aVF, and ST segment changes (elevation or depression) over the left precordial leads, were all significantly more frequent in patients with a fatal outcome. Overall, 29% of the patients who exhibited at least one of these abnormalities on admission did not survive to hospital discharge, as opposed to only 11% of the patients without a pathological 12-lead ECG. Multivariate analysis revealed that the presence of at least one of the above ECG findings was, besides haemodynamic instability, syncope and pre-existing chronic pulmonary disease, a significant independent predictor of outcome.

In conclusion, ECG may be a useful, simple, non-costly tool for initial risk stratification of patients with acute major pulmonary embolism.

This article has been cited by other articles:

				R. M. Subramaniam, J. Mandrekar, C. Chang, D. Blair, K. Gilbert, P. J. Peller, J. Sleigh, and N. Karalus Pulmonary Embolism Outcome: A Prospective Evaluation of CT Pulmonary Angiographic Clot Burden Score and ECG Score Am. J. Roentgenol., June 1, 2008; 190(6): 1599 - 1604. [Abstract] [Full Text] [PDF]

				S. Z. Goldhaber Assessing the Prognosis of Acute Pulmonary Embolism: Tricks of the Trade Chest, February 1, 2008; 133(2): 334 - 336. [Full Text] [PDF]

				D. Jimenez ECG for risk stratification in patients with pulmonary embolism Eur. Respir. J., August 1, 2005; 26(2): 366 - 367. [Full Text] [PDF]

				S. Konstantinides From the authors Eur. Respir. J., August 1, 2005; 26(2): 367 - 367. [Full Text] [PDF]