title: Serial changes in negative T wave on electrocardiogram in acute pulmonary thromboembolism.
abstract: A negative T wave is frequently observed in precordial ECG leads in patients with acute pulmonary thromboembolism. We investigated the clinical significance of negative T wave in 15 patients with acute pulmonary thromboembolism who were treated with thrombolytic agents by measuring the mean pulmonary artery pressure and ratio of right to left ventricular end-diastolic diameter using echocardiography and ECG. The study included only patients with massive acute pulmonary thromboembolism of a mean age of 65+/-9.7 years (+/-SD). A negative T wave was observed on admission in 10 patients but was later detected in 14 of the 15 patients. The mean amplitude of the negative T wave increased within 1 week then decreased after thrombolytic treatment. The peak negative amplitude of the T wave was observed from 1 to 7 days (mean, 2.6+/-1.8 days) and disappeared afterwards. During this period, improvements in both the mean pulmonary artery pressure (37.8+/-11.2 to 19.1+/-6.7 mmHg) and the ratio of right to left ventricular end-diastolic diameter (0.97+/-0.16 to 0.51+/-0.13) were noted in all patients. Our results suggest that an increase in the amplitude of negative T wave in precordial leads after thrombolytic therapy in patients with massive acute pulmonary thromboembolism reflects improvement in cardiopulmonary hemodynamics.
authors.affiliation: Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yoshinaga
authors.forename: S
authors.initials: S
authors.lastname: Ikeda
authors.forename: E
authors.initials: E
authors.lastname: Nishimura
authors.forename: K
authors.initials: K
authors.lastname: Shioguchi
authors.forename: M
authors.initials: M
authors.lastname: Shikuwa
authors.forename: Y
authors.initials: Y
authors.lastname: Miyahara
authors.forename: S
authors.initials: S
authors.lastname: Kohno
mesh_terms: D000368:Aged; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology*; D011669:Pulmonary Wedge Pressure; D015912:Thrombolytic Therapy