Acute pulmonary embolism as the cause of global T wave inversion and QT prolongation. A case report.
A 57-year-old man without prior history of organic heart disease was admitted with a diagnosis of unstable angina because of chest pain and new electrocardiographic (ECG) changes of global T wave inversion and QT interval prolongation. Left and right heart catheterization with coronary angiography, pulmonary angiography, ventilation-perfusion scintigraphy, and echocardiography showed absence of coronary artery disease but unequivocally acute pulmonary embolism. Within days following anticoagulant therapy, the lengthened QT interval became normalized while the global T wave inversion persisted. A follow-up ECG 15 months later revealed complete resolution of the T wave inversion. The possible pathophysiologic mechanism of the ECG changes is discussed.
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DVA Medical Center-Salem, Virginia.
D000208:Acute Disease; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011859:Radiography