Electrocardiographic T-wave inversion: differential diagnosis in the chest pain patient.
Inverted T waves produced by myocardial ischemia are classically narrow and symmetric. T-wave inversion (TWI) associated with an acute coronary syndrome (ACS) is morphologically characterized by an isoelectric ST segment that is usually bowed upward (ie, concave) and followed by a sharp symmetric downstroke. The terms coronary T wave and coved T wave have been used to describe these ischemic TWIs. Prominent, deeply inverted, and widely splayed T waves are more characteristic of non-ACS conditions such as juvenile T-wave patterns, left ventricular hypertrophy, acute myocarditis, Wolff-Parkinson-White syndrome, acute pulmonary embolism, cerebrovascular accident, bundle branch block, and later stages of pericarditis.
Hayden
Geoffrey E
GE
Department of Emergency Medicine, University of Virginia, Charlottesville, VA, USA.
Brady
William J
WJ
Perron
Andrew D
AD
Somers
Michael P
MP
Mattu
Amal
A
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000209:etiology; D002037:Bundle-Branch Block / Q000175:diagnosis; D002637:Chest Pain / Q000175:diagnosis* / Q000209:etiology; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004070:Digitalis / Q000009:adverse effects; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011226:Pre-Excitation Syndromes / Q000175:diagnosis; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis; D020521:Stroke / Q000150:complications / Q000175:diagnosis