Spontaneous, resolving S1Q3T3 in pulmonary embolism: A case report and literature review on prognostic value of electrocardiography score for pulmonary embolism

• ECG findings in patients with PE have been described since 1935.
• It has been extrapolated that “S1Q3T3” is a sign of right ventricular change secondary to occlusion of the pulmonary vascular system.
• Spontaneous resolution of changes demonstrates one example of an ECG’s potential variation.
• ECG remains a minimally invasive and quick tool to aid emergency physicians in the diagnosis of certain pathologies.
• The “ECG score” demonstrates that it can also provide prognostic information of patients suspected to have PE.

BackgroundElectrocardiography findings in patients with pulmonary embolism have been investigated since 1935. As medicine has evolved, more effective modalities have surpassed the electrocardiogram in diagnostic utility. Despite the advent of these other modalities, the diagnosis of pulmonary embolism remains elusive and the prognosis is variable amongst each clinical presentation of its pathology.Case report and literature reviewAfter presenting a case of a resolving S1Q3T3 in subsequent electrocardiogram findings of a patient with pulmonary embolism, this literature review will provide information on a 21-point electrocardiogram scoring system that helps the emergency physician stratify the risk of a patient with an acute presentation of pulmonary embolism. Why should emergency care staff be aware of this? Given the time-sensitive nature of diagnosis and appropriate treatment, Electrocardiogram continues to be a tool in the assessment of patients with a clinical suspicion of pulmonary embolism. Based on the information provided, 21-point electrocardiogram score has been shown to have strong usefulness in assessing prognosis of patients presenting with acute pulmonary embolism.