The early diagnosis value of electrocardiographic characteristics in acute embolism in the pulmonary trunk and the main pulmonary arteries

Abstract

Objective To investigate the abnormal characteristics of electrocardiogram and its early diagnostic value in acute pulmonary embolism (PE) of different positions. Methods A total of 147 hospitalized patients of acute PE diagnosed by the pulmonary artery CT angiography(CTA)were enrolled in this study and divided into the following two groups: pulmonary trunk or main pulmonary artery (MPA) embolism (group A)and lobar artery or remote branch embolism(group B). ECG, D-dimer, BNP, cTnT were collected and determined, the varieties of abnormal ECG were counted. Then, the relationships between the severities of the PEs at different positions and the corresponding ECG abnormalities as well as the degree of right ventricular hypertrophy (RVH) were analyzed. Results There were significant differences in dyspnea, syncope, in-hospital mortality and the level of cTnT, BNP between the two groups(P<0.05). There were significant differences in the occurrence of SIQⅢTⅢ, right bundle branch block(RBBB), ST segment depression(STD)in leads Ⅲ and aVF, ST segment elevation(STE) in lead aVR, negative T waves (NTWs) in leads Ⅲ and aVF, STD in leads V1-V3/V6,and STE in leads V1-V3 in combination with STD in leads V4-V6 between the two groups(P<0.05). The proportion of RVH diagnosed via ECG has significantly different between the two groups. The result of correlation analysis showed that the incidence of pulmonary trunk or MPA embolism was significantly related to the number of ECG abnormalities (r=0.782, t= -7.086, P<0.05). Conclusions The number of abnormal ECGs increase and the RVH is more serious when PE occurring in pulmonary trunk as well as in the MPA, early recognition of electrocardiographic abnormalities is of greater value in the diagnosis of acute pulmonary trunk and MPA embolism. Key words: Pulmonary embolism; Electrocardiogram; Pulmonary trunk; Main pulmonary artery