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Massive pulmonary embolism with ST elevation in leads V1–V3 and successful thrombolysis with tenecteplase
  1. I G Livaditis,
  2. M Paraschos,
  3. K Dimopoulos
  1. 1st Cardiology Department, Red Cross Hospital, Athens, Greece
  1. Correspondence to:
    Dr Ioannis G Livaditis
    Red Cross Hospital, Athens 11635, Greece;


A 42 year old woman was referred to the emergency department from the radiology department after having a syncopal episode during a triplex examination of the lower extremities for acute painful right leg swelling five hours earlier that morning. She had no significant medical history, smoked 3–5 cigarettes a day, and had been taking contraceptive medication for menorrhagia for the preceding three months. On presentation she was cyanotic, dyspnoeic, and haemodynamically unstable. ECG showed sinus tachycardia of 120 beats/min with ST elevations from V1 through V3 mimicking anteroseptal acute myocardial infarction. Ten minutes after presentation she was thrombolysed with 80 mg tenecteplase leading to ST elevation resolution and remarkable haemodynamic recovery after 20 minutes. This case shows how pulmonary embolism can mimic anteroseptal acute myocardial infarction on ECG and the life saving results from rapid thrombolysis with tenecteplase.

  • AMI, acute myocardial infarction
  • CT, computed tomography
  • PE, pulmonary embolism
  • RBBB, right bundle branch block
  • IVC, inferior vena cava
  • precordial ST elevation
  • pulmonary embolism
  • tenecteplase
  • anteroseptal myocardial infarction
  • thrombolysis

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