ECG in pulmonary embolism

Sinus tach (30-50%)
Right axis (S1QIIITIII)
RBBB
Ventricular or supraventricular arrhythmia
STD or STE
Anterior +/- inferior TWI

Associated with hemodynamic instability:
TWI in V1-V2
STE in aVR, V1-V2
Any STE/STD
Tachycardia (sinus, fib, flutter)
Signs of RH strain

 

Shopp JD, Stewart LK, Emmett TW, Kline JA. Findings From 12-lead Electrocardiography That Predict Circulatory Shock From Pulmonary Embolism: Systematic Review and Meta-analysis. Acad Emerg Med 2015;22(10):1127–37. PMID:26394330