Recognition
- • Sinus tachycardia (most common)
- • S1Q3T3 pattern (classic but rare)
- • T-wave inversion V1–V4
- • Incomplete/complete RBBB
- • Right axis deviation
- • P-pulmonale
Key findings
- • Non-specific — normal ECG does not exclude PE
Clinical importance
- • Signs of RV strain (TWI V1–V4, S1Q3T3) predict poor prognosis
Management pearls
- • Risk stratify (PESI, hs-troponin, echo)
- • Anticoagulation ± thrombolysis in massive PE with instability
