THE CORRELATION OF SEVERITY OF PULMONARY EMBOLISM IN CT ANGIOGRAPHY WITH ECG FINDINGS IN PATIENTS WITH ACUTE PULMONARY EMBOLISM

The most common diagnostic modality for pulmonary emboli is CT
angiography (CTA). Because of the availability and inexpensiveness, taking an electrocardiogram
(ECG) is the first step in patients suspicious to pulmonary emboli. However, ECG does not provide
any sensitive or specific manifestations for diagnosis of pulmonary emboli. We aim to evaluate the
correlation between severity of pulmonary emboli in CTA and ECG changes.
Materials & Methods: In this study, 102 patients diagnosed with massive or submassive pulmonary
emboli due to Qanadli index in CTA studies were evaluated. ECG was taking in all patients. There are
35 previously reported pathologic changes in ECG which were all evaluated in these patients. The
correlation between ECG findings and pulmonary emboli severity in CTA was evaluated.
Results: Massive emboli were present in 56.9% and submassive emboli in 43.1% of cases. In 76.5%
of cases, pathologic changes in ECG considering emboli were present. In cases with massive emboli
compared to submassive emboli, ECG changes (86.2% vs. 63.6%) and mean pathologic findings in
ECG (5.82±2.95 vs. 4.25±2.84) were significantly higher. Prevalence of S1O3T3, S1&SaVL>1.5 mm,
ST depression in V1-V3, ST elevation in V1-V3, Negative T wave in V1-V3, Right axis deviation, RVH
criteria, P-pulmonale, QR pattern in V1 were significantly higher in massive emboli group.
Conclusion: ECG changes and number of pathologic findings were higher in massive emboli group.
Most significant changes were negative T and ST depression or elevation in V1-V3 and right heart
involvement findings and could predict severity of pulmonary emboli