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Assessing and responding to sudden deterioration in the adult
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
The T wave represents ventricular repolarisation. It is normally a gradual upstroke and a rapid downstroke. The T can however be affected in some individuals, for example, those who have ischaemia of the myocardium or coronary heart disease. Changes in this wave require further investigation and treatment.
The patient with acute cardiovascular problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
The PQRST complex has been described earlier in the chapter. Sinus rhythm has the following characteristics (see also Table 6.7): Rate of between 60–100 beats per minute.Regular.P wave is present.P-R interval is normal (between 0.12–0.20 seconds or three to five small squares on ECG paper).QRS complex follows the P wave (duration less than 0.12 seconds or 3 small squares on ECG paper.ST segment on isoelectric line.T wave is present.
Genetically Determined Ventricular Arrhythmias
Published in Andrea Natale, Oussama M. Wazni, Kalyanam Shivkumar, Francis E. Marchlinski, Handbook of Cardiac Electrophysiology, 2020
Houman Khakpour, Jason S. Bradfield
T-wave morphology can provide important additional diagnostic and prognostic clues (Figures 8.1 and 8.2): Macroscopic T-wave alternans—a marker of cardiac electrical instability—though infrequently seen, should prompt an evaluation for LQTS.14Extremely broad-based T-wave are seen in LQT1.Notches on the T-wave are typical of LQT2 and their presence (compared to genetically proven LQT2 without notching) is a marker for higher risk of arrhythmic events.15LQT3 show peaked T-waves preceded by a long, isoelectric ST segment.
The correlation between T-wave abnormalities and adverse cardiovascular events and echocardiographic changes in hypertensive patients
Published in Clinical and Experimental Hypertension, 2023
Shengnan Liu, Chao Zhang, Jing Wan
Previous studies of patients with nonspecific major T-wave abnormalities have observed that isolated minor T-wave abnormalities are associated with an increased risk of cardiovascular disease and coronary heart disease mortality (15–17). In addition, a review of the clinical significance of minor nonspecific ST-segment and T-wave abnormalities in asymptomatic subjects suggested that minor T-wave abnormalities are important risk factors for coronary and cardiovascular mortality(18). In order to investigate the clinical effect of T-wave abnormalities on this specific population of hypertensive patients and so as to further clarify the predictive value of T-wave abnormalities in ECG for CVD in hypertensive patients, we only included patients who were first diagnosed with hypertension in this analysis, and the results showed that the incidence of MACE was significantly higher in hypertensive patients with abnormal T-wave than those with normal T-wave (141 [54.9%] vs 120 [69.4%], P = .003).
Initial and terminal T wave angle as hyperkalemia indicator in chronic kidney disease
Published in Postgraduate Medicine, 2022
Eka Prasetya Budi Mulia, Kevin Luke, Filipus Michael Yofrido, Rerdin Julario
The mean of Ti-Tp duration, Tp-Tt duration, Tia, Tta, and potassium level are presented in Table 1. The data distribution of all mentioned variables were not distributed normally (p < 0.001; <0.001; <0.001; <0.001; and 0.024). In addition, a significant difference between initial and terminal duration (p < 0.001), as well as the angle (0.002), was observed. The T wave was shorter and steeper at the terminal portion. Ti-Tp duration, Tp-Tt duration, Tia, Tta, and Tp amplitude were significantly higher in the hyperkalemia (potassium >5.0) group (Table 1). A Spearman correlation analysis demonstrated a significant positive correlation of Tia (r = 0.346 and p < 0.001) and Tta (r = 0.445 and p < 0.001) with potassium levels in the participants (Figure 2).
Prolongation of QTc interval due to increased parity and great grand multiparity
Published in Journal of Obstetrics and Gynaecology, 2022
Mehmet Ozgeyik, Ozge Turgay Yildirim
ECGs were taken by trained health-care personnel. The 12-lead electrocardiogram (ECG) was recorded at a paper speed of 25 mm/s (Hewlett Packard, Page-writer, Palo Alto, CA) in the supine position. ECGs were performed while the patient was at rest. Anamneses and patient evaluation were performed by cardiology specialists. A 12-lead surface ECG was obtained from all the patients. All of the ECGs were scanned and transferred to a personal computer to decrease the error measurements, and then used for ×300% magnification at computers. All ECG measurements were performed manually by two cardiology specialists and mean of the measurements were used for the study. Physicians were blinded about the parity groups during the measurements. The QT interval was identified as the time interval between the beginning of the QRS complex and the downslope of the T wave. The QTc interval was calculated using Bazett’s formula (Bazett 1920). The Tp–Te interval was measured from the peak of the T wave to the end of the T wave. The end of the T wave was defined as the intersection of the tangent to the downslope of the T wave and the isoelectric line (Perkiömaki et al. 1995). All leads are examined and QT interval was measured from the longest QT interval of all leads. Interobserver and intraobserver coefficients of variations were 2.3% and 2.7%, respectively.