A 65 year old man presents with severe chest pain and difficulty in breathing. His ECG showed S1Q3T3 pattern with sinus tachycardia. The above ECG suggest the following diagnosis:
**Core Concept**
The S1Q3T3 pattern on an ECG is a classic electrocardiographic finding associated with acute pulmonary embolism (PE). This pattern is characterized by an S wave in lead I, a Q wave in lead III, and an inverted T wave in lead III.
**Why the Correct Answer is Right**
The S1Q3T3 pattern is thought to be due to the increased pressure in the pulmonary arteries, which causes a shift in the electrical axis of the heart. This shift results in the S wave in lead I and the Q wave in lead III. The inverted T wave in lead III is a result of the altered repolarization pattern in the right ventricle. The presence of sinus tachycardia further supports this diagnosis, as it is a common response to the stress of acute PE.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is likely referring to acute myocardial infarction (AMI), which can also present with chest pain and ECG changes. However, the S1Q3T3 pattern is more specific to PE.
* **Option B:** This option is likely referring to chronic obstructive pulmonary disease (COPD), which can cause chronic changes in the ECG but not typically the S1Q3T3 pattern.
* **Option C:** This option is likely referring to cardiac tamponade, which can cause electrical alternans on the ECG but not typically the S1Q3T3 pattern.
**Clinical Pearl / High-Yield Fact**
The S1Q3T3 pattern is a classic but not exclusive finding in acute pulmonary embolism. It is essential to consider the clinical context and other diagnostic findings to confirm the diagnosis.
**Correct Answer: C. Acute Pulmonary Embolism.**