Persistent juvenile T-wave pattern
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: Juvenile T waves
Overview
The Juvenile T-wave pattern refers to a normal electrocardiographic variant in which T wave inversions are present in precordial leads V1, V2, and V3 along with an early repolarization pattern. Shallow T-wave inversion is usually found in the right precordial leads (V1-V3) during infancy. T wave then rises upwards during childhood. If this inverted T-wave pattern sustained to adulthood, it is called persistent juvenile T-wave pattern.
Natuarl History, Complications, Prognosis
Juvenile T-waves may persists into adulthood with no adverse sequela.
Differentiating persistent Juvenile T-wave pattern from other causes of T-wave inversion
Persistent juvenile T-wave inversion must be differentiated from other diseases that cause T-wave inversion, such as:
- Arrhythmogenic RV dysplasia should be suspected in this cohort if the T wave inversion persists beyond lead V1 in a post pubertal male athlete
- Cerebrovascular accidents can cause deep widely splayed T waves referred to as cerebral T waves
- 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
- Pulmonary embolism, particularly in the anterior precordium
Epidemiology and Demographics
- Juvenile T wave pattern is more commonly seen in black people—it has been shown in 10.8% of black population and 0.3% of white subjects.[1]
Diagnosis
Electrocardiogram
Treatment
Juvenile T wave pattern can be normalized by the following medications:
| Medications | Dosag |
|---|---|
| Oral potassium bicarbonate-citrate | 10 gm |
| Intravenous pro-banthīne | 20–30 mg |
References
- ↑ Wasserburger, Richard H. (1955). "Observations on the "juvenile pattern" of adult Negro males". The American Journal of Medicine. 18 (3): 428–437. doi:10.1016/0002-9343(55)90223-0. ISSN 0002-9343.
- ↑ Assali AR, Khamaysi N, Birnbaum Y (1997). "Juvenile ECG pattern in adult black Arabs". J Electrocardiol. 30 (2): 87–90. doi:10.1016/s0022-0736(97)80014-3. PMID 9141601.
- ↑ Ashcroft, M.T.; Miller, G.J.; Beadnell, H.M.S.G.; Swan, A.V. (1971). "A comparison of T-wave inversion, S-T elevation, and RS amplitudes in precordial leads of Africans and Indians in Guyana". American Heart Journal. 81 (4): 467–475. doi:10.1016/0002-8703(71)90360-7. ISSN 0002-8703.