Aslanger Pattern: An unusual electrocardiogram in Acute pulmonary Embolism

Introduction: Pulmonary embolism (PE) is a critical condition that can present with diverse and often non-specific electrocardiographic findings. The Aslanger pattern, identified in 2020, is an uncommon electrocardiography (ECG) finding typically associated with acute non-ST-segment elevation myocardial infarction (NSTEMI). Although this pattern is usually linked to myocardial infarction with significant coronary stenosis, we report a rare case where the Aslanger pattern was observed in a patient with acute pulmonary embolism. Case Presentation: A 52-year-old male with Parkinson’s disease presented with sudden chest pain, shortness of breath, sweating, and fatigue. Initial ECG showed Aslanger pattern, suggesting acute coronary syndrome. Despite elevated troponin I (1624 ng/mL) and normal coronary angiography, further investigation revealed right ventricular dilation and massive pulmonary embolism confirmed by CT angiography. The patient was treated with thrombolytics and anticoagulation, stabilizing over five days and discharged on rivaroxaban. Conclusion: The Aslanger pattern usually linked to myocardial infarction can also occur in acute pulmonary embolism. This case underscores the need for careful differential diagnosis and timely treatment to prevent complications associated with delayed care. Keywords: pulmonary embolism, Aslanger pattern, electrocardiogram