T Wave Inversion: Causes & Reasons

Possible Causes for T Wave Inversion

ST depression & T-wave inversion ST depression & T-wave inversion ST returns to baseline, but T-wave inversion persists Ischemia Oct 15, 2010 January 2004 Infarction Fibrosis [slideshare.net]

/3 height of R Wave Unless isolated in Lead III T Wave inversion Significant unless isolated to Lead III or Lead V1 T Wave must be at least 1 mm deep ST-T elevation (>1mm [fpnotebook.com]

wave inversion, suggesting evolved anterior wall myocardial infarction (AWMI). [cardiophile.org]

Unstable Angina

May include ST depression and/or T-wave inversion; unlike STEMI, there is no Q-wave development. [accessmedicine.mhmedical.com]

wave inversion). [en.wikipedia.org]

The initialchanges on ECG that justified inclusion in the study were anisolated T-wave inversion in 50 patients (20%) and deviation in theST segment in 196 (80%), 146 with [revespcardiol.org]

Lateral Myocardial Infarction

These feature are suggestive of posterior wall infarction, being the inverse of Q wave, ST elevation and T wave inversion which would have been recorded in a posterior lead [cardiophile.org]

Within a few hours, you can begin to see negative T waves or T wave inversion as the MI evolves. The T wave inversion can persist for months after the MI. [dummies.com]

Pericarditis

[…] have Q waves during evolution ST-segment elevation in middle and left precordial leads, but may be widespread Upward convex ST-segment elevation May have T-wave inversion [aafp.org]

As the disease progresses so may the ECG: there may be notched T waves, biphasic T waves or T wave inversion. [rcemlearning.co.uk]

There may also be PR interval depression – and if both of these are present it is pretty much diagnostic for pericarditis Later there may also be T wave inversion – especially [almostadoctor.co.uk]

Arrhythmogenic Right Ventricular Dysplasia

The patient had T-wave inversion in the inferior ECG leads and no history of arrhythmias. [ncbi.nlm.nih.gov]

T-wave inversion in leads V1-V3, right ventricular wall motion abnormalities, and frequent ventricular extrasystoles were the most sensitive/specific markers for identification [ncbi.nlm.nih.gov]

However, 11 of them showed minor ECG/echocardiographic abnormalities: eight had T-wave inversion in leads V1 and V2, a 36-year-old woman had T-wave inversion in leads V1 through [doi.org]

Left Ventricular Hypertrophy

[…] plus largest S wave in precordial leads > 45 mm Non Voltage Criteria Increased R wave peak time > 50 ms in leads V5 or V6 ST segment depression and T wave inversion in the [lifeinthefastlane.com]

Furthermore, delayed repolarization as a result of ventricular hypertrophy generally produces ST depression and T wave inversion in the same leads. [meds.queensu.ca]

LVH by voltage criteria: S wave in V2 + R wave in V5 > 35 mm LV strain pattern: ST depression and T wave inversion in the lateral leads Causes of LVH Hypertension (most common [lifeinthefastlane.com]

Hypertrophic Cardiomyopathy

His electrocardiogram exhibited a biphasic T wave in lead V2 with ST depressions in leads V3-V6 with deep symmetrical T-wave inversions in these leads as well. [ncbi.nlm.nih.gov]

Giant T wave inversions in the precordial leads Inverted T waves are also seen in the inferior and lateral leads. [lifeinthefastlane.com]

The hallmark electrocardiographic findings of unusually large T-wave inversions, in conjunction with the most common presenting symptom being chest pain, makes this disease [ncbi.nlm.nih.gov]

Right Bundle Branch Block

Typical RSR’ pattern (‘M’-shaped QRS) in V1 Wide slurred S wave in lead I Typical pattern of T-wave inversion in V1-3 with RBBB Causes of Right Bundle Branch Block Right ventricular [lifeinthefastlane.com]

Normal sinus rhythm, right bundle branch block, multiple ST segment abnormalities, S1Q3T3 pattern, and T wave inversion V1-V3. [journals.lww.com]

Delayed activation of the right ventricle also gives rise to secondary repolarization abnormalities, with ST depression and T wave inversion in the right precordial leads. [lifeinthefastlane.com]

Acute Myocarditis

Abstract BACKGROUND: The pathophysiologic mechanisms and the prognostic meaning of electrocardiographic (ECG) T-wave inversion (TWI) occurring in a subgroup of patients with [ncbi.nlm.nih.gov]

Thereafter, T-wave inversion typically ensues. The T-wave inversion may be discrete and lasts for one month. [ecgwaves.com]

Relationship between T-wave inversion and transmural myocardial edema as evidenced by cardiac magnetic resonance in patients with clinically suspected acute myocarditis: clinical [scielo.cl]

Secondary Cardiomyopathy

[…] with no history of CAD, and frequent T-wave inversion. [aafp.org]

These may include electrocardiogram (ECG) changes of QT prolongation and T wave inversion, elevated biochemical markers of myocardial damage and heart failure, and decreased [link.springer.com]

inversion in leads I and aVL (=3mm) (with QRS–T wave axis difference =30°), V3–V6 (=3mm) or II and III and aVF (=5mm) Abnormal Q (>40 ms or >25% R wave) in at least two leads [textbookofcardiology.org]

Myocardial Infarction

Electrocardiography showed a sinus rhythm with Q-wave formation in the inferior wall leads (II, III, aVF), T-wave inversion in the same leads, and borderline QT prolongation [ncbi.nlm.nih.gov]

ST segment depression and T wave inversion are associated with subendocardial infarction. [histopathology-india.net]

Am J Cardiol. 1967; 20: 494–508 Abstract | Full Text PDF | PubMed | Scopus (161) | Google ScholarSee all References while patients with only T-wave inversion were found to [journal.chestnet.org]

Chronic Constrictive Pericarditis

[…] have Q waves during evolution ST-segment elevation in middle and left precordial leads, but may be widespread Upward convex ST-segment elevation May have T-wave inversion [aafp.org]

wave inversions may develop In general, infection is the most common cause of pericarditis. [radiopaedia.org]

Electrocardiogram demonstrated sinus rhythm ( n = 30), low voltage QRS complex ( n = 30), flattening or T-wave inversion ( n = 29), and premature ventricular contraction [annals.in]

Bacterial Myocarditis

ECG changes may include ST segment elevation in = 2 contiguous leads, T wave inversion, widespread ST depression and pathological Q waves. [inmo.ie]

The electrocardiogram (ECG) showed T wave inversion in the lateral and inferior leads. The chest pain resolved within 24 hours of admission. [bmcinfectdis.biomedcentral.com]

Markers of myocardial damage ( troponin or creatine kinase cardiac isoenzymes) are elevated. [10] The ECG findings most commonly seen in myocarditis are diffuse T wave inversions [en.wikipedia.org]

Fungal Myocarditis

Physical agents Electric shock Hyperpyrexia Radiation/radiotherapy Investigations ECG: changes may include ST-segment elevation/depression, T-wave inversion, atrial arrhythmias [patient.info]

In one report, either ST-segment elevation or T-wave inversion was present as the most sensitive ECG criterion in 26 ]. [intechopen.com]

Acute Myocardial Infarction

This is because LBBB alone can produce signs that may be confused with those of infarction: deep QS waves in the right chest leads and ST depression and T wave inversion in [medicine-on-line.com]

Biphasic/inverted T waves in V1-5. Poor R wave progression (R wave height < 3mm in V3). Abnormal Q waves and T-wave inversion in I and aVL. [lifeinthefastlane.com]

Left main coronary artery occlusion : widespread ST depression with ST elevation in aVR ≥ V1 Wellens syndrome : deep precordial T wave inversions or biphasic T waves in V2 [lifeinthefastlane.com]

Cardiomyopathy

[…] with no history of CAD, and frequent T-wave inversion. [aafp.org]

ECG T-wave inversion in right precordial leads (V 2 and V 3 ) 2. SAECG Late potentials seen on signal-averaged ECG 3. [ncbi.nlm.nih.gov]

and frequent T-wave inversion Echocardiography shows LVH of unknown etiology with reduction in ventricular chamber volume Pharmacologic therapy based on the 2005 ACC/AHA [aafp.org]

Variant Angina Pectoris

wave inversion or flattening from previous MI Exercise ECG Thallium test Coronary angiography Exclude precipitating factors – anaemia, diabetes, hyperlipidaemia, thyrotoxicosis [medicalnotesonline.blogspot.com]

Once again, ECGs demonstrated T-wave inversion in V1–3. A repeat test showed that cTnI level was elevated at 0.4 ng/L. [smj.org.sg]

Miwa K, Kambara H, Kawai C, Murakami T. Two electrocardiographic patterns with or without transient T-wave inversion during recovery periods of variant anginal attacks. [emedicine.medscape.com]

Myocardial Contusion

The 12-lead surface ECG showed ST-elevation in lead V 3 and deep T-wave inversions across the precordial leads ( Figure 1 A). [circ.ahajournals.org]

She evolved favorably, with no progression of the pericardial effusion, although electrocardiographically she presented more T-wave inversion in the anterior wall and minimal [elsevier.es]

[…] left ventricular procedure with transmitter inserted into esophagus (transesophageal echocardiogram) Electrocardiogram (ECG) Normal PQRST pattern ST segment depression, T-wave [medical-dictionary.thefreedictionary.com]

Ventricular Aneurysm

ECG Examples Example 1 Anterior Left Ventricular Aneurysm: Minimal ST elevation in V1-3 associated with deep Q waves and T-wave inversion. [litfl.com]

Primary Cardiomyopathy

[…] with no history of CAD, and frequent T-wave inversion. [aafp.org]

Patients present with an abrupt onset of angina-like chest pain, and have diffuse T-wave inversion, sometimes preceded by ST-segment elevation, and mild cardiac enzyme elevation [academic.oup.com]

and frequent T-wave inversion Echocardiography shows LVH of unknown etiology with reduction in ventricular chamber volume Pharmacologic therapy based on the 2005 ACC/AHA [aafp.org]

Hypersensitivity Myocarditis

Physical agents Electric shock Hyperpyrexia Radiation/radiotherapy Investigations ECG: changes may include ST-segment elevation/depression, T-wave inversion, atrial arrhythmias [patient.info]

Electrocardiography showed diffuse depression of the ST segment, inversion of the T wave, Q waves in leads V 1 and V 2, and frequent premature ventricular contractions. [nejm.org]

Anomalies of Coronary Artery Origin

Resting electrocardiogram demonstrated incomplete right bundle branch block and T wave inversion in inferior leads. [ispub.com]

His electrocardiogram revealed normal sinus rhythm at a rate of 80 beats/min, left axis deviation, left atrial abnormality, and T-wave inversion in lead V 6. [read.nxtbook.com]

The resting electrocardiogram demonstrated incomplete right bundle branch block and T wave inversion in the inferior leads. [ispub.com]

Angina Pectoris

Whereas for patients who have myocardial infarction, it illustrates a T-wave inversion and ST segment depression or elevation. [differencebetween.net]

During an attack, ST depression or T-wave inversion may be seen. [radiopaedia.org]

An EKG should always be performed in cases in which patients seek medical attention – signs of coronary ischemia may include ST-segment depression and T-wave inversion; occasionally [cancertherapyadvisor.com]

Mitral Valve Prolapse

inversion in I–aVL; Q wave in inferior leads T-wave inversion in V 1 –V 2 T-wave inversion in V 1 –V 3 T-wave inversion in V 1 –V 3 Echocardiographic findings Maximal septal [dx.doi.org]

The most common abnormality is the presence of ST-T wave depression or T-wave inversion in the inferior leads (II, III and aVF). 13 MVP is associated with an increased incidence [aafp.org]

T-Wave Inversion Inverted T-waves beyond lead V 1 are common in children. [dx.doi.org]

Electrolyte Imbalance

T-waves become wider with lower amplitude. T-wave inversion may occur in severe hypokalaemia. [ecgwaves.com]

 ECG manifestations are primarily due to delayed ventricular repolarization and include T-wave flattening and inversion,  an increasingly prominent U wave, ST- segment [slideshare.net]

Patients with left ventricular hypertrophy may instead display normalization of secondary T-wave inversions (lead V5, V6, aVL, I). [ecgwaves.com]

Subarachnoid Hemorrhage

ECG Electrocardiographic manifestations are non-specific, but commonly include: deep, symmetric T wave inversions 12 often referred to as "cerebral T waves" prolongation of [radiopaedia.org]

ECG may show Tall T waves, ST depression, Giant T wave inversions secondary to raised ICP, QT prolongation and arrhythmias. [emdidactic.blogspot.com]

ECG changes in 50‐100% of patients due to neurogenic myocardial stunning and coronary vasospasm: deep, wide precordial T‐wave inversion, bradycardia, and prolonged QT – beware [emergencymedicinecases.com]

Myxedema

ECGs of myxedema coma patients have three classic features: 1) bradycardia, 2) low voltage, and 3) widespread T-wave inversions. [sinaiem.org]

Other findings include low voltage, flattening or inversion of the T waves, and prolongation of the PR interval. [emjournal.net]

Fabry Disease

ECG showed sinus rhythm, shortened PR interval, widespread t wave inversion, q waves in the lateral leads and left ventricular hypertrophy (LVH). [ncbi.nlm.nih.gov]

Resting ECG showed T wave inversion in lateral chest leads, I and aVL. [academic.oup.com]

Common initial electrocardiographic abnormalities include sinus bradycardia, nonspecific ST-segment changes, T-wave inversion, and shortened PR interval. [emedicine.medscape.com]

Restrictive Cardiomyopathy

LV, left ventricle; RV, right ventricle; RA, right atrium. ( b ) 12-lead ECG in sinus rhythm with prominent P-waves in all leads, T-wave inversions, and incomplete right bundle [jci.org]

[…] with no history of CAD, and frequent T-wave inversion. [aafp.org]

and frequent T-wave inversion Echocardiography shows LVH of unknown etiology with reduction in ventricular chamber volume Pharmacologic therapy based on the 2005 ACC/AHA [aafp.org]

Left Cardiac Ventricle Disorder

wave inversion, abnormal Q waves Laboratory: slightly ↑ troponin T;, ↑ BNP Echocardiography: apical left ventricular ballooning, ↓ LVEF Coronary angiography: usually no pathological [amboss.com]

Arrhythmogenic right ventricular cardiomyopathy is a relatively rare disorder with ECG characteristics of T wave inversion in the anteroseptal leads and epsilon waves. [onlinelibrary.wiley.com]

[…] spasms and dysfunction → myocardial stunning Clinical findings: similar to ACS Diagnostics ECG: ST elevation (or, less commonly, ST depression), QT interval prolongation, T [amboss.com]