scholarly journals Memory T-waves, a rare cause of T-wave inversion in the emergency department

2020 ◽  
Vol 13 (4) ◽  
pp. 312
Author(s):  
R Gunaseelan ◽  
M Sasikumar ◽  
K Aswin ◽  
B Nithya ◽  
N Balamurugan ◽  
...  
2017 ◽  
Vol 6 (4) ◽  
Author(s):  
Layal Mansour MD ◽  
Elie Chammas MD, FESC, FACC ◽  
Fida Charif MD ◽  
Mohamad Jihad Mansour

<p><em>A 48-year-old male was admitted to the emergency department because of intermittent chest pain of 2 days duration. At the time of examination, he was pain-free. An electrocardiogram (ECG) showed biphasic T waves in leads V2 to V6. Troponin-I level was negative. During his transfer to the cardiac catheterization laboratory, he had a short episode of chest pain. His ECG was normal. Despite the unusual extension of biphasic T waves to the lateral precordial leads, the condition was recognized as Wellens’ syndrome, which typically associates biphasic or deep symmetric T wave inversion in leads V2 and V3 during pain-free periods with a critical stenosis in the proximal left anterior descending artery. The syndrome is uncommon to medical practice but should be recognized immediately in the emergency department because it represents a pre-infarction stage and carries a high risk of mortality. </em><em></em></p>


2010 ◽  
Vol 139 (2) ◽  
pp. e15-e17 ◽  
Author(s):  
Shinpei Kimura ◽  
Wataru Mitsuma ◽  
Masahiro Ito ◽  
Hiromi Suzuki ◽  
Yukio Hosaka ◽  
...  
Keyword(s):  
T Wave ◽  

2018 ◽  
Vol 46 (11) ◽  
pp. 4845-4851
Author(s):  
Xiqiang Wang ◽  
Jingjing Sun ◽  
Zhuokun Feng ◽  
Yuan Gao ◽  
Chaofeng Sun ◽  
...  

Wellens’ syndrome is characterised by particular changes in electrocardiogram (ECG) precordial lead T-waves accompanied by proximal stenosis of the left anterior descending (LAD) artery. Two cases of electrocardiographic changes associated with Wellens’ syndrome are presented here. Case 1, a 55-year-old female, was transferred to the First Affiliated Hospital of Xi’an Jiaotong University with intermittent and laborious angina pectoris. Her first ECG on admission revealed T-wave inversion in leads V1–V3 and biphasic T-waves in V4. Case 2, an 85-year-old female, presented with dyspnoea and paroxysmal chest pain. Her admission ECG displayed asymmetrical T-wave inversion in leads V1–V3, I, and aVL, and depressed ST segments in leads V2–V5. In this patient, drug-eluting stents were placed on a LAD artery lesion and right coronary artery occlusion. The potential of ECGs to aid decision-making in severe myocardial infarction is straightforward, particularly in patients with characteristic ECGs, however, Wellens’ syndrome has a wide spectrum of clinical manifestations and the ECG patterns may manifest itself persistently over a period of weeks. Therefore, ECG parameters should be combined with coronary angiography to confirm the presence of lesions.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abdolmohammad Ranjbar ◽  
Bahram Sohrabi ◽  
Seyyed-Reza Sadat-Ebrahimi ◽  
Samad Ghaffari ◽  
Babak Kazemi ◽  
...  

Abstract Background Up to over half of the patients with ST-segment elevation myocardial infarction (STEMI) are reported to undergo spontaneous reperfusion without therapeutic interventions. Our objective was to evaluate the applicability of T wave inversion in electrocardiography (ECG) of patients with STEMI as an indicator of early spontaneous reperfusion. Methods In this prospective study, patients with STEMI admitted to a tertiary referral hospital were studied over a 3-year period. ECG was obtained at the time of admission and patients underwent a PPCI. The association between early T wave inversion and patency of the infarct-related artery was investigated in both anterior and non-anterior STEMI. Results Overall, 1025 patients were included in the study. Anterior STEMI was seen in 592 patients (57.7%) and non-anterior STEMI in 433 patients (42.2%). Among those with anterior STEMI, 62 patients (10.4%) had inverted T and 530 (89.6%) had positive T waves. In patients with anterior STEMI and inverted T waves, a significantly higher TIMI flow was detected (p value = 0.001); however, this relationship was not seen in non-anterior STEMI. Conclusion In on-admission ECG of patients with anterior STEMI, concomitant inverted T wave in leads with ST elevation could be a proper marker of spontaneous reperfusion of infarct related artery.


2020 ◽  
pp. 1-3
Author(s):  
Simona Boroni Grazioli ◽  
Marc-Philip Hitz ◽  
Inga Voges

Abstract A 17-year-old boy with a history of dyspnea attacks and chest pain was referred to our paediatric cardiology department. Electrocardiogram at presentation showed T-wave inversion in the inferior leads. Cardiovascular magnetic resonance imaging revealed the rare diagnosis of apical hypertrophic cardiomyopathy with subendocardial late gadolinium enhancement, missed by echocardiography.


2021 ◽  
Vol 14 (2) ◽  
pp. e241047
Author(s):  
Vanesa Anton-Vazquez ◽  
Laura Byrne ◽  
Lisa Anderson ◽  
Lisa Hamzah

We report a case of cardiac injury in a 46-year-old man affected by COVID-19. The patient presented with shortness of breath and fever. ECG revealed sinus tachycardia with ventricular extrasystoles and T-wave inversion in anterior leads. Troponin T and N-terminal pro B-type natriuretic peptide were elevated. Transthoracic echocardiography showed severely reduced systolic function with an estimated left ventricle ejection fraction of 30%. A nasopharingeal swab was positive for SARS-CoV-2. On day 6, 11 days after onset of symptoms, the patient deteriorated clinically with new chest pain and type 1 respiratory failure. Treatment with colchicine 0.5 mg 8-hourly resulted in rapid clinical resolution. This case report highlights how cardiac injury can dominate the clinical picture in COVID-19 infection. The role of colchicine therapy should be further studied to determine its usefulness in reducing myocardial and possibly lung parenchymal inflammatory responses.


2014 ◽  
Vol 46 ◽  
pp. 890-891
Author(s):  
Hiroyuki Ishida ◽  
Norimitsu Kinoshita ◽  
Tatsuo Sakai ◽  
Fuminori Katsukawa

2019 ◽  
Vol 11 (1) ◽  
pp. 68-70
Author(s):  
Mahmut Yesin ◽  
Turgut Karabağ ◽  
Macit Kalçık ◽  
Süleyman Karakoyun ◽  
Metin Çağdaş ◽  
...  

The symptoms of aortic dissection (AD) may be highly variable and may mimic other much common conditions. Thus, a high index of suspicion should be maintaned, especially when the risk factors for AD are present or signs and symptoms suggest this possibility. However, sometimes AD may be asymptomatic or progression may be subclinical. Various electrocardiographical (ECG) changes may be seen in AD patients such as ST segment elevation in aVR as well as ST segment depression and T-wave inversion. In this case report, we reported a patient with acute AD whose ECG revealed ST segment elevation in aVR lead in addition to diffuse ST segment depression in other leads.


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