ArticleAnnals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc2014
Electrocardiogram patterns during hemodynamic instability in patients with acute pulmonary embolism.
Article in Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Pooled it
- Use of fragmented QRS in prognosticating clinical deterioration and mortality in pulmonary embolism: A meta-analysis.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2018Pooled it
- The value of electrocardiography in prognosticating clinical deterioration and mortality in acute pulmonary embolism: A systematic review and meta-analysis.Clinical cardiology · 2017Pooled it
- Artificial Intelligence-Driven Integration of ECG and Molecular Biomarkers in Pulmonary Embolism.International journal of molecular sciences · 2026Review
- Dynamic ST-Segment Elevation in Massive Pulmonary Embolism Captured by Holter Electrocardiography: A Case Report.Cureus · 2026Article
- ST Elevation in aVR: An Atypical Presentation of Pulmonary Embolism.Clinical case reports · 2025Article
- Prevalence of Electrocardiographic Abnormalities in Patients with Acute Pulmonary Embolism: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- Acute pulmonary embolism with electrocardiogram showing subtotal left main coronary artery occlusion: A case report.Heliyon · 2024Article
- Differentiating electrocardiographic indications of massive and submassive pulmonary embolism: A cross-sectional study in Southern Iran from 2015 to 2020.Clinical cardiology · 2024Article
- Algorithms of Electrocardiographic Changes for Quantitative and Localization Analysis of Thrombus Burden in Patients with Acute Pulmonary Thromboembolism.Reviews in cardiovascular medicine · 2023Article
- Prognostic value of fragmented QRS in acute pulmonary embolism: a cross-sectional-analytic study of the Iranian population.American journal of cardiovascular disease · 2023Article
- The Role of ECG in the Diagnosis and Risk Stratification of Acute Coronary Syndromes: an Old but Indispensable Tool.Current cardiology reports · 2022Review
- A Novel Electrocardiography Model for the Diagnosis of Acute Pulmonary Embolism.Frontiers in cardiovascular medicine · 2022Article
- Massive pulmonary embolism presenting with hemoptysis and S1Q3T3 ECG findings.BMC cardiovascular disorders · 2021Article
- Electrocardiographic right ventricular strain precedes hypoxic pulseless electrical activity cardiac arrests: Looking beyond pulmonary embolism.Resuscitation · 2020Article
- Unusual presentation of acute pulmonary embolus presenting with inferior ST elevation.BMJ case reports · 2018Article
- Imaging of acute pulmonary embolism: an update.Cardiovascular diagnosis and therapy · 2018Review
- Development of massive pulmonary embolism during echocardiographic imaging: A case report.Medicine · 2018Article
- Unique ECG Findings in Acute Pulmonary Embolism: STE with Reciprocal Changes and Pathologic Q Wave.Case reports in critical care · 2018Article
- Correlations between electrocardiogram and biomarkers in acute pulmonary embolism: Analysis of ZATPOL-2 Registry.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2017Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe have previously described new electrocardiogram (ECG) findings for massive pulmonary embolism, namely ST-segment elevation in lead aVR with ST-segment depression in leads I and V4 -V6 . However, the ECG patterns of patients with acute pulmonary embolism during hemodynamic instability are not fully described.
methodsWe compared the differences between the ECG at baseline and after deterioration during hemodynamic instability in twenty patients with acute pulmonary embolism.
resultsCompared with the ECG at baseline, three ischemic ECG patterns were found during clinical deterioration with hemodynamic instability: ST-segment elevation in lead aVR with concomitant ST-segment depression in leads I and V4 -V6 , ST-segment elevation in leads V1 -V3 /V4 , and ST-segment elevation in leads III and/or V1 /V2 with concomitant ST-segment depression in leads V4 /V5 -V6 . Ischemic ECG patterns with concomitant S1Q3 and/or abnormal QRS morphology in lead V1 were more common (90%) during hemodynamic instability than at baseline (5%) (P = 0.001).
conclusionsHemodynamic instability in acute pulmonary embolism is reflected by signs of myocardial ischemia combined with the right ventricular strain pattern in the 12-lead ECG.
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