The electrocardiogram in pulmonary embolism.

The importance of the electrocardiogram in the diagnosis of pulmonary embolism was first demonstrated by McGinn and White (1935) but general opinion still varies concerning the precise diagnostic value of this method of investigation. As recently as 1952 Newman stated that in only 10-20 per cent of cases of pulmonary embolism is there a characteristic pattern and that electro-cardiographic examination is not a good method of making the diagnosis. By contrast, Phillips and Levine (1950) are of the opinion that the diagnosis of pulmonary embolism can be made with a high degree of accuracy and, indeed, that the first clue to the diagnosis may often be found by this method. The object of this paper is to analyse in detail the electrocardiograms of 50 undoubted cases of pulmonary embolism and to compare these results with those of other workers in order to assess its value in making the diagnosis. In addition, an attempt is made to correlate the severity of the clinical picture with the electrocardiogram, and also to show how the presence or absence of pulmonary infarction affects it.