Fig. 1

Case 1, Sinus tachycardia.

Fig. 2

Case 2, T wave inversions in leads V1 to V4.

Fig. 3

Case 4, Right bundle branch block.

Fig. 4

Case 5, Sinus tachycardia with S1Q3T3 pattern.

Fig. 5

Case 6, Normal sinus rhythm with S1Q3T3 pattern not related to PE.

Fig. 6

Atrial fibrillation with a rapid ventricular response is seen in this ECG obtained in a middle-aged female patient with dyspnea after prolonged bed rest. V/Q scanning was high probability for PE. She had no past history of atrial fibrillation.

Fig. 7

Right bundle branch block, signified by an rSR pattern in lead V1 in the setting of a widened QRS complex, in a patient with documented PE. Also note the likely right ventricular hypertrophy (RVH) pattern, large R' wave in lead V1 and large S waves in the mid to left precordial leads. Lastly, the chronic pulmonary disease pattern is suggested in this particular patient, RVH and low voltage in the limb leads.

Fig. 8

Another example of RBBB, RVH, and the chronic pulmonary disease pattern in a patient with PE.

Fig. 9

(A) Sinus tachycardia with nonspecific changes in a patient with dyspnea, plueritic chest pain, and hypoxemia. Subsequent evaluation revealed PE. (B) After admission to a critical care unit, P-pulmonale was noted in this tracing with large P waves in lead II.

Fig. 10

A large S wave in lead I is seen in a PE patient.

Fig. 11

Sinus tachycardia and ST segment depression in leads V2 to V6 in a PE patient.

Fig. 12

ST segment elevation in leads V2 to V5 is seen in a PE patient. Additionally, T wave inversions are also seen in this distribution.

Fig. 13

Numerous findings as suggested by Sreeram et al¹⁴ consistent with PE are noted, including incomplete RBBB, right axis deviation (~120 degrees), large S waves in leads I and aVI, and T wave inversions in the anterior and inferior leads. In addition to the Sreeram et al¹⁴ criteria, RVH (prominent R' wave in lead V1 with right axis deviation) with strain (ST segment/T wave changes) is noted.