From the Department of Emergency Medicine, Memorial Hospital of Southern Oklahoma, Ardmore, OK, USA
the Department of Medicine, University of Oklahoma Health Sciences Center, the Arthritis and Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK. USA
the Department of Veterans Affairs Medical Center, Oklahoma City, OK. USA
From the Department of Emergency Medicine, Memorial Hospital of Southern Oklahoma, Ardmore, OK, USA
the Department of Medicine, University of Oklahoma Health Sciences Center, the Arthritis and Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK. USA
the Department of Veterans Affairs Medical Center, Oklahoma City, OK. USA
Correspondence
Address reprint requests to Dr Scofield, Oklahoma Medical Research Foundation, 825 NE 13th St, Oklahoma City, OK 73104.
From the Department of Emergency Medicine, Memorial Hospital of Southern Oklahoma, Ardmore, OK, USA
the Department of Medicine, University of Oklahoma Health Sciences Center, the Arthritis and Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK. USA
the Department of Veterans Affairs Medical Center, Oklahoma City, OK. USA
Correspondence
Address reprint requests to Dr Scofield, Oklahoma Medical Research Foundation, 825 NE 13th St, Oklahoma City, OK 73104.
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Abstract
An 18-year-old man presented with a spontaneous right pneumothorax. An initial electrocardiogram (ECG) showed an S wave in lead I, a Q wave in lead III, and an inverted T wave in lead III. This ECG pattern, S1Q3T3, has been most often associated with pulmonary embolus. These changes resolved with partial reexpansion of the lung. Both right and left pneumothorax have been associated with ECG changes, including changes that mimic myocardial ischemia. Because the clinical presentation of pneumothorax may be similar to angina or pulmonary embolus, ECG changes with pneumothorax may lead to confusion in the diagnosis.
