McGinn-White pattern

History of the McGinn-White pattern

1935 – McGinn and White first described the so-called S₁Q₃T₃ pattern in five patients with acute cor pulmonale secondary to pulmonary embolism.

(1)The prominent S wave and low origin of the T wave in lead 1, the ST segment starting slightly below the baseline, (2) the gradual staircase ascent of the ST interval from the S wave to the T wave in lead 2, and especially (3) the Q wave and definite late inversion of the T wave in lead 3. 

McGinn, White. 1935

Reported in around 24% of patients with pulmonary embolism with a high specificity. Associated with an increased risk of circulatory shock and mortality

Associated Persons

• Sylvester McGinn (1904–1984)
• Paul Dudley White (1886–1973)

References

Historical references

• McGinn S, White PD. Acute cor pulmonale resulting from pulmonary embolism. JAMA. 1935; 104(17): 1473-1480 [McGinn-White pattern; and defined acute cor pulmonale]

Eponymous term review

• Scott RC. The S1Q3 (McGinn-White) pattern in acute cor pulmonale: a form of transient left posterior hemiblock? Am Heart J. 1971 Jul;82(1):135-7. 
• Daniel KR, Courtney DM, Kline JA. Assessment of cardiac stress from massive pulmonary embolism with 12-lead ECG. Chest. 2001 Aug;120(2):474-81. [Daniel score]
• Shopp JD, Stewart LK, Emmett TW, Kline JA. Findings From 12-lead Electrocardiography That Predict Circulatory Shock From Pulmonary Embolism: Systematic Review and Meta-analysis. Acad Emerg Med. 2015 Oct;22(10):1127-37.
• Thomson D, Kourounis G, Trenear R, Messow CM, Hrobar P, Mackay A, Isles C. ECG in suspected pulmonary embolism. Postgrad Med J. 2019 Jan;95(1119):12-17.
• Carrascosa MF, Izquierdo RG, Hoz MC. McGinn-White pattern. Eur J Intern Med. 2020 Sep;79:112-113.
• Elsayed YMH. McGinn-White Sign or S1Q3T3-Pattern in Pulmonary Embolism; Significance and Differential Diagnosis; Narrative Updating Review. International Journal of Research Studies in Medical and Health Sciences. 2020; 5(11): 15-24
• Karn M, Yonghang S, Barma A, Sharma A. The classic S1Q3T3/McGinn-White sign in acute pulmonary embolism. QJM. 2024 Sep 1;117(9):665-666
• Teng F, Chen YX, He XH, Guo SB. Contribution of Quick Sequential Organ Failure Assessment Score Combined with Electrocardiography in Risk Stratification of Patients with Acute Pulmonary Embolism. Chin Med J (Engl). 2018 Oct 20;131(20):2395-2401.
• Golzarian H, Chakraborty S, Shaikh MU, Hinegardner-Hendricks J, Toro DF. Severe Acute Cor Pulmonale With Impending Shock: An Insidious Incidental. JACC Case Rep. 2024 Feb 9;29(6):102241