Annals of Emergency Medicine
Volume 55, Issue 4 , Pages 331-335 , April 2010

12-Lead ECG Findings of Pulmonary Hypertension Occur More Frequently in Emergency Department Patients With Pulmonary Embolism Than in Patients Without Pulmonary Embolism

  • Michael R. Marchick, MD

      Affiliations

    • Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC
    • ,
  • D. Mark Courtney, MD

      Affiliations

    • Department of Emergency Medicine, Northwestern University, Chicago, IL
    • ,
  • Christopher Kabrhel, MD, MPH

      Affiliations

    • Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
    • ,
  • Kristen E. Nordenholz, MD

      Affiliations

    • Department of Surgery, University of Colorado, Denver, CO
    • ,
  • Michael C. Plewa, MD

      Affiliations

    • Department of Emergency Medicine, St. Vincent Mercy Medical, Toledo, OH
    • ,
  • Peter B. Richman, MD, MBA

      Affiliations

    • Department of Emergency Medicine, Mayo Clinic, Scottsdale, AZ
    • ,
  • Howard A. Smithline, MD

      Affiliations

    • Department of Emergency Medicine, Baystate Medical Center, Springfield, MA
    • ,
  • Jeffrey A. Kline, MD

      Affiliations

    • Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC
    • Corresponding Author InformationAddress for reprints: Jeffrey A. Kline, MD, Emergency Medicine Research, Department of Emergency Medicine, Carolinas Medical Center, PO Box 32861, Charlotte, NC 28323-2861; 704-355-7092, fax 704-355-7047

Received 7 April 2009 ,Revised 25 June 2009 ,Accepted 24 July 2009.

References 

  1. Van Mieghem C, Sabbe M, Knockaert D. The clinical value of the ECG in noncardiac conditions. Chest. 2004;125:1561–1576
  2. Punukollu G, Gowda RM, Vasavada BC, et al. Role of electrocardiography in identifying right ventricular dysfunction in acute pulmonary embolism. Am J Cardiol. 2005;96:450–452
  3. Geibel A, Zehender M, Kasper W, et al. Prognostic value of the ECG on admission in patients with acute major pulmonary embolism. Eur Respir J. 2005;25:843–848
  4. Daniel KR, Courtney DM, Kline JA. Assessment of cardiac stress from massive pulmonary embolism with 12-lead ECG. Chest. 2001;120:474–481
  5. Iles S, Le Heron CJ, Davies G, et al. ECG score predicts those with the greatest percentage of perfusion defects due to acute pulmonary thromboembolic disease. Chest. 2004;125:1651–1656
  6. Toosi MS, Merlino JD, Leeper KV. Electrocardiographic score and short-term outcomes of acute pulmonary embolism. Am J Cardiol. 2007;100:1172–1176
  7. Richman PB, Louti H, Lester SJ, et al. Electrocardiographic findings in emergency department patients with pulmonary embolism. J Emerg Med. 2004;27:121–126
  8. Stein PD, Terrin ML, Hales CA, et al. Clinical, laboratory, roentgenographic, and electrocardiographic findings in patients with acute pulmonary embolism and no pre-existing cardiac or pulmonary disease. Chest. 1991;100:598–603
  9. Rodger M, Makropoulos D, Turek M, et al. Diagnostic value of the electrocardiogram in suspected pulmonary embolism. Am J Cardiol. 2000;86:807–809
  10. Kline JA, Courtney DM, Kabrhel C, et al. Prospective multicenter evaluation of the pulmonary embolism rule-out criteria. J Thromb Haemost. 2008;6:772–780

 Supervising editor: Allan B. Wolfson, MD

 Author contributions: MRM analyzed the data and drafted the article. DMC, CK, KEN, MCP, PBR, HAS, and JAK participated in data collection and revision of the original draft of the article. JAK conceived the study, obtained funding, and takes responsibility for the paper as a whole.

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. Supported by grants from the National Institutes of Health, R41HL074415 and R42HL074415, K23HL077404 and R01 HL074384.

 Publication date: Available online September 19, 2009.

 Please see page 332 for the Editor's Capsule Summary of this article.

PII: S0196-0644(09)01285-2

doi: 10.1016/j.annemergmed.2009.07.025

Annals of Emergency Medicine
Volume 55, Issue 4 , Pages 331-335 , April 2010

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