# S1Q3T3 Electrocardiographic Pattern in a Case of Colonic Ileus: A Case Report

## TL;DR

A patient with a bowel blockage showed an ECG pattern typically linked to lung clots, but it resolved after treating the bowel issue.

## Contribution

This case report highlights an unusual association between colonic ileus and the S1Q3T3 ECG pattern.

## Key findings

- A postoperative patient with colonic ileus exhibited the S1Q3T3 ECG pattern and new-onset atrial fibrillation.
- The ECG abnormalities resolved after the ileus symptoms were treated.
- This suggests that acute abdominal conditions can mimic pulmonary or cardiac pathologies on ECG.

## Abstract

The S1Q3T3 electrocardiographic (ECG) pattern is commonly described in patients with acute pulmonary embolism (PE). However, it is a nonspecific, nonsensitive ECG finding associated with right heart strain that can be found in other acute presentations as well. Most of these acute diseases are of cardiac or pulmonary origin and pathophysiology. Acute abdominal pathologies are not well-known etiologies for this characteristic ECG pattern. We present a case of postoperative colonic dilation and ileus that showed up as acute, new atrial fibrillation (AF) associated with the S1Q3T3 pattern and that resolved after the resolution of the ileus symptoms.