Sat27November0445PM 19

Which of the following is a common feature of severe pulmonary embolism?

(Please select 1 option)

Long PR interval on the electrocardiogram

Tricuspid incompetence Incorrect answer selected

Metabolic alkalosis

Increased left atrial pressure

Anterior T wave inversion on the electrocardiogram This is the correct answer

Explanation

In most cases of pumonary embolism there is just a sinus tachycardia on the ECG. In severe cases (e.g. right atrial dilatation and right ventricular hypertrophy/dilatation) there may be a change in the electrical axis characterised by an S wave in lead I and a Q wave and T wave inversion in lead III (S1Q3T3), sinus tachycardia, T wave inversion in leads V1-V3, (precordial/anterior leads over the right ventricle) and small QRS complexes.

A long PR interval on the electrocardiogram indicates first degree heart block. It is also associated with hypokalaemia.

There may be decreased left atrial pressure if the PE is massive.

There may be a metabolic acidosis.

Pulmonary hypertension and right heart failure may be the presenting features of multiple pulmonary emboli.

Answer Statistics

1

1%

2

64%

3

5%

4

4%

5

28%

Times answered: 299