title: Isolated T Wave Inversion in Lead aVL: An ECG Survey and a Case Report.
abstract: Background. Computerized electrocardiogram (ECG) analysis has been of tremendous help for noncardiologists, but can we rely on it? The importance of ST depression and T wave inversions in lead aVL has not been emphasized and not well recognized across all specialties. Objective. This study's goal was to analyze if there is a discrepancy of interpretation by physicians from different specialties and a computer-generated ECG reading in regard to a TWI in lead aVL. Methods. In this multidisciplinary prospective study, a single ECG with isolated TWI in lead aVL that was interpreted by the computer as normal was given to all participants to interpret in writing. The readings by all physicians were compared by level of education and by specialty to one another and to the computer interpretation. Results. A total of 191 physicians participated in the study. Of the 191 physicians 48 (25.1%) identified and 143 (74.9%) did not identify the isolated TWI in lead aVL. Conclusion. Our study demonstrated that 74.9% did not recognize the abnormality. New and subtle ECG findings should be emphasized in their training so as not to miss significant findings that could cause morbidity and mortality.
authors.affiliation: Lutheran Medical Center, Department of Emergency Medicine, Brooklyn, NY 11220, USA ; NYMC, Metropolitan Hospital Center, Department of Emergency Medicine, New York, NY 10029, USA ; Department of Emergency Medicine, St. George's University School of Medicine, St. George's, Grenada.
authors.forename: Getaw Worku
authors.initials: GW
authors.lastname: Hassen
authors.affiliation: NYMC, Metropolitan Hospital Center, Department of Emergency Medicine, New York, NY 10029, USA.
authors.forename: Ana
authors.initials: A
authors.lastname: Costea
authors.affiliation: School of Osteopathic Medicine, A.T. Still University, Mesa, AZ 85206, USA.
authors.forename: Claire
authors.initials: C
authors.lastname: Carrazco
authors.affiliation: Bellevue Medical Center, Department of Emergency Medicine, New York, NY 10016, USA.
authors.forename: Tsion
authors.initials: T
authors.lastname: Frew
authors.affiliation: Bellevue Medical Center, Department of Emergency Medicine, New York, NY 10016, USA.
authors.forename: Anand
authors.initials: A
authors.lastname: Swaminathan
authors.affiliation: Department of Internal Medicine, NYU, New York, NY 10016, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Feliberti
authors.affiliation: NYMC, Metropolitan Hospital Center, Department of Emergency Medicine, New York, NY 10029, USA.
authors.forename: Roger
authors.initials: R
authors.lastname: Chirurgi
authors.affiliation: Medgar Evers College, Brooklyn, NY 11225, USA.
authors.forename: Tennyson
authors.initials: T
authors.lastname: Smith
authors.affiliation: School of Osteopathic Medicine, A.T. Still University, Mesa, AZ 85206, USA.
authors.forename: Alice
authors.initials: A
authors.lastname: Chen
authors.affiliation: Lutheran Medical Center, Department of Family Practice, Brooklyn, NY 11220, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Thompson
authors.affiliation: Lutheran Medical Center, Department of Family Practice, Brooklyn, NY 11220, USA.
authors.forename: Neola
authors.initials: N
authors.lastname: Gushway-Henry
authors.affiliation: Lutheran Medical Center, Department of Emergency Medicine, Brooklyn, NY 11220, USA ; Department of Emergency Medicine, St. George's University School of Medicine, St. George's, Grenada.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Simmons
authors.affiliation: Lutheran Medical Center, Department of Internal Medicine, Brooklyn, NY 11220, USA.
authors.forename: George
authors.initials: G
authors.lastname: Fernaine
authors.affiliation: NYMC, Metropolitan Hospital Center, Department of Emergency Medicine, New York, NY 10029, USA.
authors.forename: Hossein
authors.initials: H
authors.lastname: Kalantari
authors.affiliation: NYMC, Metropolitan Hospital Center, Department of Internal Medicine, New York, NY 10029, USA.
authors.forename: Soheila
authors.initials: S
authors.lastname: Talebi