The ECG shows the S1Q3T3 pattern. This “classic” finding is neither sensitive nor specific for PTE and found in only 20% of patients with PTE. Thus, ECG findings only in combination with physical symptoms suggest PTE. Although ST-elevation may be seen in the PTE, in this case they are due to early repolarization.

Here are the most common ECG findings in patients with PTE:

• Sinus tachycardia
• S1Q3T3 pattern
• New-onset atrial fibrillation or flutter
• incomplete right bundle branch block
• right axis deviation
• T-wave inversion in leads V1 to V4