Electrocardiogram-based Case Study

ECG CORNERtoward the left, 90° away from the lead III, inscribing T inversion therein.Increased stimulation of the sympathetic nervous system due to pain, anxiety, and hypoxia can contribute to sinus tachycardia.• An obese diabetic female with DVT of the lower limbs suggests a prothrombotic milieu.Sudden-onset breathlessness in this situation raises suspicion of pulmonary thromboembolism.An elevated serum D-dimer level strongly supports this diagnosis, and CTPA provides confirmatory evidence. HistoryA 48-year-old obese diabetic female (random blood sugar 550 mg) with chest pain and breathlessness. Deep vein thrombosis (DVT) (both lower limbs).The following is the electrocardiogram (ECG) of the concerned case, presented in Figure 1. Findings o n ECg• Sinus tachycardia.• T inversion in leads II, III, aVF, and V1, V3-V6 (T vector = -45° on hexagonal lead system).• Clockwise rotation.• Low-voltage QRS over chest leads (<10 mm amplitude). rElEvant invEstigationsD-dimer was elevated (6230 ng/mL; normal, <550 ng/mL), and computed tomography pulmonary angiography (CTPA) confirmed pulmonary thromboembolism. CommEntsAcute pulmonary embolism (PE) usually causes right ventricular strain with its dilatation.There may be a shift of the T vector more