Q. I wanted to make sure if the attached EKG is good? Please comment.

Answered by
Dr. Ahmed Goha
and medically reviewed by Dr. Chithranjali Ravichandran
This is a premium question & answer published on Apr 11, 2021

Hello doctor,

I just want to make sure if this EKG is good? No ischemia, or pulmonary embolism, or anything?

#

Hi,

Welcome to icliniq.com.

From the attached reports (attachments removed to protect the patient's identity), ECG is normal. There is no ischemia.

Hello doctor,

Is there no pulmonary embolism either?

#

Hi,

Welcome back to icliniq.com.

No, this is normal tracing. There is only non-specific T wave inversion in the lead III, which does not mean ischemia or pulmonary embolism.

ECG sensitivity is low in the diagnosis of ischemia or pulmonary embolism.

Hello doctor,

I think I saw inversions in lead v1 to v3?

#

Hi,

Welcome back to icliniq.com.

T wave inversion is seen in V1 and V2 and not in V3, which is normal in young age females.

Hello doctor,

No, I do not have any symptoms. But I thought you said I had an inversion on lead III. Now it is v1 and v2.

I am confused.

#

Hi,

Welcome back to icliniq.com.

Let me clarify, and I did not mention the inversions in lead V1 and V2 because this is considered normal for young females, and the additional finding in the ECG was the T wave inversion in the lead III, which is non-specific. Did you have ECG as a part of a routine check-up? Do you have any risk factors for coronary artery disease (CAD), smoking, hypertension, DM (diabetes mellitus), high lipid profile, or a family history of CAD? I would like to assure you that the ECG does not indicate that you have CAD or pulmonary embolism.

Hi doctor,

The ECG said borderline T abnormalities anterior lead. And I happen to be looking online, and it said different stuff. So I just wanted to make sure that it was not a pulmonary embolism. I am assuming that there are other things on ECG you look for PE.

#

Hi,

Welcome back to icliniq.com.

The typical ECG changes for pulmonary embolism are the presence of S1 in the lead I, Q wave in the lead III, and T wave inversion in the lead III. However, this is not the case in many cases. Pulmonary embolism is diagnosed primarily by symptoms, mainly shortness of breath, chest pain, fainting, with clinical suspicion due to associated hypercoagulable status such as post-operative, deep venous thrombosis, etc.

Hello doctor,

I am a 40-year-old woman. The ECG that I sent you hopefully you can see it good? Does it not have any of the abnormalities? I just wanted to make sure it was good?

#

Hi,

Welcome back to icliniq.com.

I understand your concern.

I assure you that your ECG does not have these changes, and it is considered within normal limits.

So you do not need to worry about the non-specific changes in the ECG.

If you still have concerns, you may consider doing further cardiac investigations, which I think you do not need in the meantime.


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