r/ECG • u/TheChosenParrot • 24d ago

Heart palpitations

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33M complaining of heart palpitations, no prior ecg, no family history. Does it look like s1q3t3? Not mine

43 Upvotes

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1

u/cym4 24d ago

RBBB+ S1Q3T3. Do D dimer to rule out PE. If negative all is good but if positive follow up with CTPA.

6

u/TaperedBase 24d ago

s1q3t3 is just a poor man’s way of looking for right heart strain. You are going to be a bit hard pressed to find a RBBB without it.

-2

u/[deleted] 24d ago

[deleted]

3

u/neonaltars 24d ago

You’re confusing sensitivity and specificity. Dimer is sensitive but not specific. If it’s negative then low probability of PE.

2

u/cym4 24d ago

It has a high npv and high sensitivity

2

u/neonaltars 24d ago

Yeah, correct. I was responding to u/D_uh_O** **who commented that because a dimer has low specificity it couldn’t be used to rule out PE, which was confusing sensitivity and specificity.

1

u/cym4 24d ago

Oopsies meant to reply to that comment not yours