The most common ECG finding in the setting of a pulmonary embolism is sinus tachycardia. However, the “S1Q3T3” pattern of acute cor pulmonale is classic; this is termed the McGinn-White Sign.

The diagnosis is pulmonary embolism and the initial treatment to correct his altered hemodynamics is aggressive IV fluids. The patient's clinic scenario of pleuritic chest pain, tachycardia ...