T wave changes: Difference between revisions
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*[[MI]] (hyperacute T waves) | *[[MI]] (hyperacute T waves) | ||
*[[Hyperkalemia]] | *[[Hyperkalemia]] | ||
*Benign Early Repolarization | *[[Benign Early Repolarization]] | ||
*[[deWinter T-waves]] (acute LAD occlusion) | |||
==See Also== | ==See Also== |
Revision as of 06:14, 15 February 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
- deWinter T-waves (acute LAD occlusion)