Summary ECG; Patients with Chest pain

ECG Patients with Chest pain


ECG Pulmonary Embolism
 Sinus tachycardia (44%)
 Sometimes
o Right axis deviation (16%)
o RBBB (18%)
o RV strain – T wave inversion and ST depression in V1, V2, V3, V4 (34%)
o SIQIIITIII (not sensitive or specific)
o Atrial tachycardias (AF, atrial flutter, MAT etc) (8%)
o NORMAL ECG in 18% of the patients

, Pericarditis ECG features
 Wide spread ST elevation concave upwards
 Wide spread PR depression = Most specific finding
 Reversed in right sided leads aVR and V1 (reciprocal changes)
 Changes are usually small (0.5-1mm)

Above Acute changes might be followed by
 T wave flattening
 T wave inversion
 Normalisation of the ECG




Left ventricular hypertrophy (LVH)
 S wave depth in V1+Tallest R wave in V5 and V6 >35mm (7 big squares)
 Left axis deviation
LVH non-voltage criteria
 LV strain  ST depression and inverted T waves in left leads
 Increased R wave peak time in V5 and V6 (50ms)