Most common ECG change in pulmonary embolism is: September 2009

Ans. B: Sinus tachycardia Pulmonary embolism is one of the most commonly missed diagnoses due to the non-specific signs and symptoms of pulmonary embolism: shoness of breath, tachypnea, dyspnea on exeion, tachycardia, and pleuritic chest pain. ECG findings noted during the acute phase of pulmonary embolism can include any number of the following: "S1Q3T3" - prominent S in lead I, Q and inveed T in lead III Right bundle branch block (RBBB), complete or incomplete, often resolving after acute phase Right shift of QRS axis Shift of transition zone from V4 to V5-6 ST elevation in VI and aVR Generalized low-amplitude QRS Sinus tachycardia is the most cited abnormality, atrial fibrillation/flutter, or right-sided PAC/PVC T wave inversion in V1-4, often a late sign.