Key result
Pulmonary embolism mimics acute anterior STEMI on ECG with Q waves and ST elevations.
Case Report (n=1)
Pulmonary embolism can present with anterior Q waves and coved ST-segment elevations mimicking an acute anterior STEMI.
Clinicians should consider PE in anterior STEMI ECG mimics; this case leaves open questions of prevalence and systematic evaluation.
A 64-year-old woman with hypertension and diabetes presented with acute shortness of breath and left-sides chest discomfort. Electrocardiopgram (ECG) demonstrated Q waves, coved ST-segment elevations, and T-wave inversions in leads V₁-V₄, suggesting acute anterior ST-elevation myocardial infarction (STEMI). catheterization revealed nonocclusive coronary artery disease with elevated pulmonary and right heart pressures, confirmed by echocardiography. Ventilation perfusion scan was deemed high probability for pulmonary embolism (PE). Treatment for a submassive PE was initiated and ECG changes resolved by discharge. This case exemplifies similarities in clinical presentation of PE and acute STEMI. The presence of Q waves in anterior leads wih coved ST-elevation after PE has not been described previously. We review the differential diagnosis of ST elevation and the assorted spectrum of ECG changes seen in PE.
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Raghav et al. (2011) conducted a case report in Pulmonary Embolism (n=1). Electrocardiography was evaluated. Pulmonary embolism can present with ECG changes mimicking acute anterior ST-elevation myocardial infarction, including Q waves and coved ST-segment elevations, necessitating careful clinical evaluation and imaging.
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