Diagnosis of acute pulmonary embolism with EKG changes Similar to acute coronary syndrome by bedside cardiac Ultrasound evaluation: case report and review of article

Acute pulmonary embolism (PE) is an emergency and life-threatening disease that despite its relatively high prevalence in ICU patients, is still difficult to diagnose due to non-specific signs and symptoms. Symptoms such as shortness of breath and chest discomfort are completely non-specific and overlap with the diagnosis of acute coronary syndrome (ACS).

EKG changes associated with acute pulmonary embolism are highly variable and can resemble acute coronary syndromes. Recently, changes in precordial leads in the form of inverted T wave have been described as a diagnostic clue of PE, although these changes are also seen in acute coronary syndrome.

In this article, we report a 92-year-old man with dyspnea and progressive hypotension. Which was initially wrongly diagnosed as acute coronary syndrome due to diffuse inverted T in precordial leads V1 to V6, and pulmonary embolism was confirmed after cardiac ultrasound evaluation at the bedside.

In this article, we will talk about the diagnosis of this case and the review of related texts, emphasizing the limitations of EKG and the importance of using cardiopulmonary ultrasound at the bedside.