T wave inversion: Difference between revisions
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*[[Pulmonary embolism]], particularly in the anterior precordium | *[[Pulmonary embolism]], particularly in the anterior precordium | ||
*[[Restrictive cardiomyopathy]] | *[[Restrictive cardiomyopathy]] |
Revision as of 16:38, 23 September 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: negative T wave; negative T waves; inverted Ts;flipped T waves; flipped T wave; flipped Ts
Overview
T wave inversion is a non-specific electrocardiographic sign in which the T wave, an electrical signal that occurs when the heart is repolarizing or recharging itself, it is upside down instead of upright.
Classification
Primary T Wave Inversion
These changes in the T wave represent a primary abnormality in electrical repolarization (i.e. they are not due to or secondary to a change in conduction). Examples include the dig effect, myocardial ischemia or central nervous system events such as subarachnoid hemorrhage.
Secondary T Wave Inversion
The T wave may be inverted as a result of changes in the sequence of ventricualr activation such as is seen with premature ventricular contractions (PVCs), left bundle branch block, right bundle branch block (RBBB) and pre excitation syndromes like WPW.
Causes
- Digoxin
- Electrolyte disturbance
- Ischemic heart disease including non ST segment elevation MI or prior MI
- Left bundle branch block, it is normal for the T wave to be inverted if the QRS complex is upright
- Left ventricular hypertrophy with strain
- Myocarditis
- Persistent juvenile T-wave pattern
- Premature ventricular contraction
- Pulmonary embolism, particularly in the anterior precordium
- Restrictive cardiomyopathy
- Subarachnoid hemorrhage
- Unstable angina
- Wellen syndrome
Post Pubertal Male Athlete
- Arrhythmogenic RV dysplasia should be suspected in this cohort if the T wave inversion persists beyond lead V1.