Key result
TV1/TV3 ratio >0.5 strongly differentiates pulmonary embolism from Wellens syndrome, occurring in 100% vs ~5%.
Why the study?
Differences in negative T waves in right precordial leads may help differentiate pulmonary embolism from Wellens syndrome but have not been well established.
Does the TV1/TV3 ratio > 0.5 help differentiate acute pulmonary embolism from Wellens syndrome in patients with anterior T-wave inversions?
Observational (n=70)
Does the TV1/TV3 ratio > 0.5 help differentiate acute pulmonary embolism from Wellens syndrome in patients with anterior T-wave inversions?
Absolute Event Rate: 100% vs 4.5%
A TV1/TV3 negative T-wave magnitude ratio > 0.5 on ECG is highly suggestive of acute pulmonary embolism rather than Wellens syndrome.
T-wave ratio may aid ECG differentiation of PE from Wellens syndrome; leaves open prospective validation before any clinical adoption.
The aim of this study is to estimate the possibility of using the differences of negative T waves in the right precordial leads for the differential diagnosis of the pulmonary thromboembolism (pulmonary embolism) and Wellens syndrome. We studied the first ECGs with T -wave inversion in leads V 1 –V 3 in 70 patients (38 patients with pulmonary embolism and 32 patients with Wellens syndrome). The ratio of the magnitude of negative T wave in the lead V 1 to the magnitude of negative T wave in the lead V 3 (T V1 /T V3 ) was more than 0.5 in all patients with pulmonary embolism and in only one (4.5%) patient with Wellens syndrome. So, this criterion T V1 /T V3 >0.5 may by useful for the differential diagnosis of these diseases.
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Мазур et al. (2020) conducted an observational in Acute pulmonary embolism and Wellens syndrome (n=70). Pulmonary embolism vs. Wellens syndrome was evaluated on Ratio of the magnitude of negative T wave in lead V1 to V3 (TV1/TV3) > 0.5. A TV1/TV3 ratio >0.5 was present in 100% of patients with pulmonary embolism compared to 4.5% of patients with Wellens syndrome.
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