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Global T waves inversion and QT prolongation. An uncommon presentation of acute pulmonary embolism

Simone Savastano, Martina Querio, Ernesto Anesi, Rita Camporotondo
  • Martina Querio
    School of Cardiovascular Disease, University of Pavia, Italy
  • Ernesto Anesi
    Emergency Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
  • Rita Camporotondo
    Intensive Coronary Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

Abstract

This is the case of a man presenting to the emergency department for dyspnea. Despite a very common symptom he presented an uncommon twelve leads electrocardiogram (ECG). At a first glance it could have suggested an acute coronary syndrome, a Takotsubo cardiomyopathy or a hypertrophic cardiomyopathy. However the further investigations showed an acute pulmonary embolism (APE) whose pre-test probability was low with a Wells score of 0 and a Geneva simplified score of 1. Negative T waves have been described in APE, however, such a morphology associated with QT prolongation is a very rare presentation. This case confirms how the diagnosis of APE could be often insidious representing a challenge for the emergency physician.

Keywords

ECG, pulmonary embolism, T waves

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Submitted: 2017-10-15 18:26:09
Published: 2018-03-12 12:26:20
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Copyright (c) 2018 Simone Savastano, Martina Querio, Ernesto Anesi, Rita Camporotondo

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