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Non-ST-elevation acute coronary syndrome frequently presents with negative T-wave inversion. In acute pulmonary embolism precordial T-wave inversion occurs due to right ventricular strain. We herein report a case of a 48-year-old woman presenting with syncope secondary to massive main pulmonary artery embolism which was initially diagnosed as acute coronary syndrome due to negative anterior T-wave inversion and raised troponin. In addition, her room air saturation was normal and electrocardiogram showed T-wave inversion in inferior wall leads as well. We present this case of massive pulmonary embolism with varied presentation which was initially misdiagnosed as acute coronary syndrome

Acute massive pulmonary embolism mimicking non-ST-elevation acute coronary syndrome