T wave changes: Difference between revisions
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[[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 | ||
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**In presence of baseline TWI (within 1 month), reocclusion causes normalization of TWI | **In presence of baseline TWI (within 1 month), reocclusion causes normalization of TWI | ||
**Should be interpreted as evidence of ischemia | **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]] | |||
*[[Pericarditis]] (stage 3) | |||
*CNS T waves (diffuse, deep) | |||
*[[ARVD]] (may also have epsilon wave) | |||
==See Also== | ==See Also== | ||
Revision as of 04:37, 25 February 2015
- Normally upright in 1, 2, V3-V6
- Negative in AVR
- If is greater than 2/3 height of R wave then is abnormal
- Deep symmetrical inverted T waves:
- Left ventricle apical hypertrophy
- Raised ICP (e.g. SAH)
- Wellen's (MI)
- Paced rhythm
- BBB's or WPW
- Idiopathic
- 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
- Pericarditis (stage 3)
- CNS T waves (diffuse, deep)
- ARVD (may also have epsilon wave)