see also: [[Pulmonary Embolism]], [[T inversion DDx]] > [!tip] > - anterioseptal + inferior T inversion can be findings in PE > - overall, can be all sorts of weird ECG findings that mimic ACS, so (as we already do), keep PE on differential list # ECG findings in PE - sinus tachycardia - only present in 30-50% of PE - S1Q3T3 - 15% of PE - [[T inversion DDx|T wave inversion]] - especially anterioseptal and/or inferior - common in large PEs - specific for PE! - >2mm TWI in V1, V2, III, aVF were found in 4% of PE cases, but was never found in patients with ACS or non-cardiac chest pain - T inversion in III and v1-v4 [specific](https://drsmithsecgblog.com/a-woman-in-her-40s-with-acute-chest/) for PE - rightward axis - new RBBB or incomplete RBBB - SVTs, even ventricular dysrhythmias - ST segment depressions or elevations # examples ## flipped T waves ![[Pasted image 20230516233304.png]] ![[Pasted image 20230516234404.png| another scary example where the patient had cardiac risk factors and this is the ECG with new T inversions. admitted, was noted to have wheezing (no hx of COPD/asthma), and got lung CT]] ![[Pasted image 20230516234528.png| chest pain, NSVT, inferior and anterio-septal T inversions. was PE!]]