What question did this study set out to answer?

This research aims to analyze the frequency of ECG abnormalities in patients with low to moderate risk pulmonary embolism and their relationship with the oxygenation index.

March 24, 2026

Electrocardiographic abnormalities in patients with low or moderate risk pulmonary embolism: Prevalence and association with PO 2 /FiO 2 ratio

Key Result

Electrocardiographic abnormalities occurred in 68.1% of low or moderate risk pulmonary embolism patients, with combined SVTs and QRS abnormalities linked to a lower PO2/FiO2 ratio (p=0.014).

Key Points

This research aims to analyze the frequency of ECG abnormalities in patients with low to moderate risk pulmonary embolism and their relationship with the oxygenation index.
Retrospective analysis of 72 outpatients diagnosed with low or moderate risk PE.
Diagnosis confirmed using CT pulmonary angiography, lung perfusion scintigraphy, or other methods.
Assessment of initial ECG findings at the time of admission.
Comparison of PO2/FiO2 ratios among patients with different ECG findings.
31.9% of patients exhibited normal ECG upon admission.
The most common abnormality was sinus tachycardia observed in 37.5% of cases.
Lower PO2/FiO2 ratios were significantly associated with patients having both supraventricular tachycardias and QRS abnormalities.

Structured PICO

Are initial ECG abnormalities associated with the oxygenation index (PO2/FiO2 ratio) in patients with low or moderate risk pulmonary embolism?

Population

72 outpatients admitted for low or moderate risk pulmonary embolism, mean age 60.4±18.5 years.

Outcome

Prevalence of initial ECG findings and their association with the oxygenation index (PO2/FiO2 ratio)surrogate

In patients with low or moderate risk pulmonary embolism, the combined presence of supraventricular tachycardias and QRS abnormalities on admission ECG is associated with worse oxygenation.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Introduction:Pulmonary embolism (PE) is a relatively common and potentially life-threatening condition. Previous studies have documented that approximately 70% of patients with mild to massive PE have an abnormal electrocardiogram (ECG). Aims and Objectives: To determine the prevalence of initial ECG findings in patients admitted for low and moderate risk PE and the possible association of those findings with the oxygenation index (PO 2 /FiO 2 ratio). Methods: Seventy two outpatients age (mean ± SD): 60.4±18.5 years admitted for low or moderate risk PE were retrospectively studied. The diagnosis was established on the basis of computed tomography pulmonary angiography in 73.6% (n=53), lung perfusion scintigraphy in 23.6% (n=17), or other methods in 2.8% (n=2) of total cases of PE. Results: Twenty three patients (31.9%) had normal ECG on admission. Sinus tachycardia was the most frequent ECG abnormality 37.5% (n=27). Other abnormalities observed were as follows: atrial fibrillation or flutter 8.3% (n=6), right bundle branch block 12.5% (n=9), “P pulmonale” 11.1% (n=8), ST segment depression 1.4% (n=1), T-wave inversion 18.1% (n=13), T-wave flattening 12.5% (n=9), and S1Q3T3 pattern 11.1% (n=8). The combined presence of supraventricular tachycardias (SVTs) and QRS abnormalities was associated with a significantly lower PO 2 /FiO 2 ratio, compared to patients with either SVTs, QRS abnormalities or normal ECG one-way ANOVA: F(3,68)=3.77, p=0.014. Conclusions:Approximately 2/3 of patients with PE have ECG abnormalities on admission. The combined presence of SVTs and QRS abnormalities is associated with lower PO 2 /FiO 2 ratio.

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