T wave changes: Difference between revisions
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*[[Pericarditis]] (stage 3) | *[[Pericarditis]] (stage 3) | ||
*CNS T waves (diffuse, deep) | *CNS T waves (diffuse, deep) | ||
*[[ | *[[Arrhythmogenic right ventricular dysplasia]] (may also have epsilon wave) | ||
*Paced rhythm | *Paced rhythm | ||
Revision as of 22:44, 4 January 2016
Diagnosis
- Normally upright in 1, 2, V3-V6
- Negative in AVR
- If is greater than 2/3 height of R wave then is abnormal
- Distribution
- T wave is normally inverted in aVR; sometimes inverted in III, aVF, aVL, V1
- T-wave inversions in V2-V6 are always pathologic
- Morphology
- Inverted, symmetric,
- Transient changes suggests ischemia without infarction
- Persistent changes suggests infarction (troponin elevation usually seen)
- Pseudonormalization
- In presence of baseline TWI (within 1 month), reocclusion causes normalization of TWI
- Should be interpreted as evidence of ischemia
Differential Diagnosis
T Wave Inversions
- Myocardial infarct (NSTEMI)
- Myocardial ischemia (Wellen's)
- Pulmonary embolism (RV strain)
- LVH with strain pattern
- Bundle branch block
- WPW
- Pericarditis (stage 3)
- CNS T waves (diffuse, deep)
- Arrhythmogenic right ventricular dysplasia (may also have epsilon wave)
- Paced rhythm
Peaked T-waves
- MI (hyperacute T waves)
- Hyperkalemia
- Benign Early Repolarization