T wave changes: Difference between revisions
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==Diagnosis== | |||
[[File:T wave morphology.png|thumb|Types of T wave morphology]] | [[File:T wave morphology.png|thumb|Types of T wave morphology]] | ||
*Normally upright in 1, 2, V3-V6 | *Normally upright in 1, 2, V3-V6 | ||
*Negative in AVR | *Negative in AVR | ||
*If is greater than 2/3 height of R wave then is abnormal | *If is greater than 2/3 height of R wave then is abnormal | ||
*Distribution | *Distribution | ||
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*[[LVH]] with strain pattern | *[[LVH]] with strain pattern | ||
*[[Bundle branch block]] | *[[Bundle branch block]] | ||
*[[WPW]] | |||
*[[Pericarditis]] (stage 3) | *[[Pericarditis]] (stage 3) | ||
*CNS T waves (diffuse, deep) | *CNS T waves (diffuse, deep) | ||
*[[ARVD]] (may also have epsilon wave) | *[[ARVD]] (may also have epsilon wave) | ||
*Paced rhythm | |||
==See Also== | ==See Also== | ||
Revision as of 04:39, 25 February 2015
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)
- ARVD (may also have epsilon wave)
- Paced rhythm