Value of standard 12-lead electrocardiogram in differential diagnosis of acute pulmonary embolism and elevation myocardial infarction / 第二军医大学学报

ABSTRACT

Objective To study the values of standard 12-lead electrocardiogram (ECG) in differential diagnosis pulmonary embolism (APE) and non-ST elevation myocardial infarction (NSTEMI). Methods A retrospective anal; conducted on 126 patients who were treated in the First Affiliated Hospital of Wenzhou Medical College during Jan. Jan. 2011. The patients included 42 patients with APE (mean age [61± 12] year) and 84 with NSTEMI (mean age [72±15] year). The data of all patients were complete and true, and the two groups were comparable in age and sex distribute standard 12-lead ECG records on admission were analyzed and the parameters which could be used for differential diagno screened. Results Frequencies of right bundle branch block (RBBB) and SI QII TII or SI SII SII pattern were similar in groups ([11. 9%] APE vs [14. 3%] NSTEMI, [26. 2%] APE vs [15. 5%] NSTEMI patients, respectively). Nej waves in leads V1-V3 together with negative T waves in inferior wall leads II, III, aVF (OR 1. 32, 95%CI[1. 15-1.69]yielded a positive predictive value of 88% and specificity of 82% for APE. However, ST depression in leads V5-V6 and negative T waves in leads V5-V6 (OR 1. 85, 95%CI [1. 14-3. 01]) yielded a positive predictive value of 89% and specificity for NSTEMI. Conclusion RBBB and SI QII TII or SI SII SII pattern may not help to differentiate between APE and NSTEMI. Co, of negative T waves in precordial leads V1-V3 and inferior wall leads II, III aVF may suggest APE diagnosis. Coexistence of T waves and ST segment depression in precordial leads V5-V6 may suggest NSTEMI diagnosis.