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The S1Q3T3 Electrocardiographic Abnormality as a Result of Massive Empyema due to Pyogenic Liver Abscess: A Case Report

Year: 2025

Type: article

Abstract: The S1Q3T3 pattern on the electrocardiogram is often associated with right heart strain in pulmonary embolism, pneumothorax, and acute lung diseases causing acute cor pulmonale. The S1Q3T3 pattern during acute massive empyema in the setting of a liver abscess has not been reported in theliterature. We present a case report of a 41-year-old Iranian female patient with a sudden onset chest pain, dyspnea, sinus tachycardia, and electrocardiography findings of S1Q3T3 pattern, who was revealed to have an expanding pyogenic pleural effusion as a result of trans-diaphragmatic extension of a liver abscess. The other causes of S1Q3T3 were excluded. The patient underwent the insertion of a chest tube to remove the pus. After chest tube insertion, the S1Q3T3 pattern resolved. Despite initial improvement, the patient developed complications, including pleural adhesions and lung collapse, and required a posterolateral thoracotomy with decortication. This resulted in dramatic clinical improvement. Rapidly expanding massive pyogenic pleural effusion can lead to the S1Q3T3 pattern on the electrocardiogram.

Source: Clinical Case Reports

DOI: 10.1002/ccr3.70191

Authors: Mahmonir Mohammadi, Mahnaz Valizadeh, Nasrin Rahmani‐ju, Yasamin Khosravaninezhad

Institutions: Islamic Azad University, Tehran, Islamic Azad University Medical Branch of Tehran

Language: English

Topic: Pleural and Pulmonary Diseases

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,820