Key result
A 66-year-old male presenting with typical chest pain and diffuse T wave inversions mimicking acute coronary syndrome was diagnosed with a saddle pulmonary embolus.
Case Report (n=1)
No
Diffuse T wave inversions can be an initial electrocardiographic presentation of acute pulmonary embolism, mimicking acute coronary syndrome.
T-wave inversions with chest pain warrant PE consideration in the ACS differential; this single case leaves open systematic validation of ECG patterns.
Acute pulmonary embolism (PE) is a life-threatening condition and is typically diagnosed by a combination of symptoms, clinical signs and imaging. Electrocardiogram may be helpful in diagnosis, and the most widely described pattern of occurrence is the so-called S 1 Q 3 T 3 pattern. Here, we describe the case of an African-American male who presented with typical chest pain, diffuse T wave inversions with serial troponin elevation. There was initial concern for Wellen's syndrome but was finally diagnosed as acute PE. This case underscores the necessity of vigilance and a lower threshold for PE work up even in patients presenting as acute coronary syndrome.
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Egini et al. (2018) conducted a case report in Acute pulmonary embolism (n=1). Diffuse T wave inversions was evaluated on Diagnosis of acute pulmonary embolism. A 66-year-old male presenting with typical chest pain and diffuse T wave inversions mimicking acute coronary syndrome was diagnosed with a saddle pulmonary embolus.
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