Dyspnoea with diffuse T wave inversion
BMJ 2022; 378 doi: https://doi.org/10.1136/bmj-2022-070894 (Published 15 September 2022) Cite this as: BMJ 2022;378:e070894
- Zhuo-Yu An, foundation doctor1,
- Ding Peng, consultant2,
- Ya-Juan Shi, consultant3,
- Chuan-Hai Zhang, consultant4
- 1Peking University Institute of Hematology, Peking University People’s Hospital, Beijing, China
- 2Department of Electrocardiography, Qingyuan People’s Hospital, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan, China
- 3Qidong People’s Hospital/Affiliated Qidong Hospital of Nantong University, Qidong, Jiangsu, China;
- 4Department of Cardiology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
- Correspondence to C-Hai Zhang zch8598145{at}yeah.net
A woman in her 50s presented with sudden onset severe chest tightness, shortness of breath, and surgical incision pain on the third day after thoracoscopic left upper lung lobectomy for lung cancer. She had not received chemotherapy or radiotherapy, and she had no family history of coronary artery disease or sudden death.
On preoperative evaluation, her electrocardiogram (ECG) had been normal (fig 1). Her vital signs were as follows: temperature 36.0°C, heart rate 100 beats/min, respiration 18 breaths/min, blood pressure 112/74 mm Hg, and oxygen saturation 95% (when inhaling oxygen 3 L/min).
ECG on patient’s admission for surgery
When she presented with chest symptoms, physical examination found normal heart sounds and no pericardial friction rub. Breath sounds from the left lung were coarse and diminished, and no significant wet rales were heard. The patient underwent a second ECG (fig 2), coagulation tests, and tests …
Log in
Log in using your username and password
Log in through your institution
Subscribe from £173 *
Subscribe and get access to all BMJ articles, and much more.
* For online subscription
Access this article for 1 day for:
£38 / $45 / €42 (excludes VAT)
You can download a PDF version for your personal record.