Key result
Electrocardiographic abnormalities, including T-wave inversion, right bundle branch block, and S1Q3T3, provide valuable prognostic information for predicting severity and adverse outcomes in patients with acute pulmonary embolism.
Why the study?
Do specific 12-lead ECG abnormalities provide prognostic value for assessing the severity of acute pulmonary embolism?
Do specific 12-lead ECG abnormalities provide prognostic value for assessing the severity of acute pulmonary embolism?
Surface 12-lead ECG abnormalities, including those in the 21-point score, offer valuable prognostic information for assessing the severity of acute pulmonary embolism.
Answers are grounded in this paper and cite their sources.
ECG abnormalities aid acute PE risk stratification; confirms prognostic value via Level 1 synthesis.
Electrocardiographic (ECG) abnormalities in the setting of acute pulmonary embolism (PE) are being increasingly characterized and mounting evidence suggests that ECG plays a valuable role in prognostication for PE. We review the historical 21-point ECG prognostic score for the severity of PE and examine the updated evidence surrounding the utility of ECG abnormalities in prognostication for severity of acute PE. We performed a literature search of MEDLINE, EMBASE, and PubMed up to February 2015. Article titles and abstracts were screened, and articles were included if they were observational studies that used a surface 12-lead ECG as the instrument for measurement, a diagnosis of PE was confirmed by imaging, arteriography or autopsy, and analysis of prognostic outcomes was performed. Thirty-six articles met our inclusion criteria. We review the prognostic value of ECG abnormalities included in the 21-point ECG score, including new evidence that has arisen since the time of its publication. We also discuss the potential prognostic value of several ECG abnormalities with newly identified prognostic value in the setting of acute PE.
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Digby et al. (2015) conducted a review in Acute pulmonary embolism. Electrocardiographic (ECG) abnormalities vs. Absence of specific ECG abnormalities was evaluated on Prognostic outcomes including mortality, cardiogenic shock, in-hospital complication, and hemodynamic deterioration. Electrocardiographic abnormalities, including T-wave inversion, right bundle branch block, and S1Q3T3, provide valuable prognostic information for predicting severity and adverse outcomes in patients with acute pulmonary embolism.
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