The diagnosis of acute pulmonary embolism has always been challenging. However, it has recently been greatly assisted through advances in radiological imaging. While imaging techniques are widely available, they cannot always be utilized. We report a case of acute pulmonary embolism in a patient with several prior pulmonary resections that would likely result in a non-diagnostic V/Q scan and acute renal insufficiency that was a relative contraindication to CT pulmonary angiography. The patient's electrocardiogram displayed several features suggestive of acute pulmonary embolism, which in the absence of effective radiological imaging, were essential in her diagnosis and management.
Keywords: ECG; Pulmonary Embolism.