ECG Findings Predict Hemodynamic Instability in Patients with Pulmonary Embolism

A meta-analysis found that a Daniel Score >5 is associated with a higher probability of shock from PE.

Treatments for hemodynamically stable patients with confirmed pulmonary embolism (PE) vary from outpatient anticoagulation to systemic fibrinolysis. Guidelines recommend that the choice of treatment be based on risk stratification via electrocardiogram (ECG), biomarker, and imaging (echocardiogram or computed tomography) findings.

The Daniel score was developed as a prognostic ECG-based prediction tool for increased pulmonary artery pressure as a sign of cardiac stress (Chest 2001; 120:474). These authors (one of whom led the development of the Daniel score) performed a systematic review and meta-analysis to determine the prognostic value of each of the score's components (tachycardia, S1Q3T3 pattern, incomplete and complete right bundle bra…

Reviewing Author

Ali S. Raja, MD, MBA, MPH, FACEP

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Board Member); American College of Healthcare Executives – Massachusetts (Board Member)

Ali S. Raja, MD, MBA, MPH, FACEP

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Board Member); American College of Healthcare Executives – Massachusetts (Board Member)

ECG Findings Predict Hemodynamic Instability in Patients with Pulmonary Embolism

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Reviewing Author