Diagnostic value of the electrocardiogram in suspected pulmonary embolism

A variety of electrocardiographic (ECG) changes have been suggested to have diagnostic value in patients with suspected pulmonary embolism (PE).(1-5) However, most of these investigations have only studied patients with confirmed PE, Few investigators have reported on the prevalence of ECG changes in patients with suspected PE. The diagnostic value of a test can only be determined by applying the test to patients with suspected disease and then determining if the test is predictive of outcome. Further, previous investigations examining the diagnostic value of the electrocardiogram in suspected PE have been limited by patient selection (critical care patients only)(6,7) or by not comparing the diagnostic value of the electrocardiogram with an appropriate reference standard (perfusion scans only).(7).