Correct!
4. Pulmonary embolism
The ECG shows an "S1Q3T3" pattern which is an S wave in lead 1 and a Q wave and inverted T wave in lead 3. Although the ECG is usually considered a poor screening test for pulmonary embolism, the S1Q3T3 pattern is seen in about 50% of patients with massive PE (1). The thoracic CT angiogram confirms a massive PE with an intracardiac clot in the right atrium (Figure 4, red arrow).
Figure 4. Thoracic CT angiogram showing the intracardiac clot (red arrow).
What therapy should the patient be given? (Click on the correct answer to proceed to the seventh and final panel)