Global T waves inversion and QT prolongation. An uncommon presentation of acute pulmonary embolism

Global T waves inversion and QT prolongation. An uncommon presentation of acute pulmonary embolism

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This is the case of google pixel 7 freedom a man presenting to the emergency department for dyspnea.Despite a very common symptom he presented an uncommon twelve leads electrocardiogram (ECG).At a first glance it could have suggested an acute coronary syndrome, a Takotsubo cardiomyopathy or a hypertrophic cardiomyopathy.

However the further investigations showed an acute pulmonary embolism (APE) whose pre-test probability was low with a Wells score of 0 and a Geneva apac1/60/1/cw simplified score of 1.Negative T waves have been described in APE, however, such a morphology associated with QT prolongation is a very rare presentation.This case confirms how the diagnosis of APE could be often insidious representing a challenge for the emergency physician.