The Electrocardiogram in Disorders of the Pulmonary Circulation

  • Massimo Romanò


The electrocardiogram (ECG) is a specific but relatively insensitive tool for diagnosing acute cor pulmonale, which is almost always caused by pulmonary embolism. Acute overload of the right ventricle is manifested by a typical triad of ECG features referred to as the S1Q3T3 complex or McGinn and White triad. It includes the presence of S waves in lead I and Q waves with T-wave inversion in lead III (Fig. 14.1). Acute cor pulmonale can also be associated with right axis deviation, transient right bundle-branch block (RBBB), and T-wave inversion in the right precordial leads (Fig. 14.2). It has been suggested that inverted T waves in lead V2 or V3 are a common ECG sign of massive pulmonary embolism. In another study on pulmonary embolism, the pseudoinfarction pattern (QR in V1) and T-wave inversion in lead V2 were strongly correlated with the presence of right ventricular dysfunction and independent predictors of an unfavorable clinical outcome.


Pulmonary Embolism Congenital Heart Disease Axis Deviation Massive Pulmonary Embolism Precordial Lead 
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Copyright information

© Springer-Verlag Milan 2015

Authors and Affiliations

  • Massimo Romanò
    • 1
  1. 1.Ospedale Civile di VigevanoVigevanoItaly

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