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The T wave
Published in Andrew R Houghton, Making Sense of the ECG, 2019
There are also several conditions in which T wave inversion occurs in combination with other ECG abnormalities. If the ECG has been normal up to this point of the assessment, it is unlikely that any of the following are to blame for the T wave inversion. Nonetheless, if you still have not found a cause after going through the aforementioned list, consider: Repolarization abnormalities following a paroxysmal tachycardiaBundle branch block (Chapters 9 and 14)Pericarditis (Chapter 15)Ventricular pacing (Chapter 21)
Cardiovascular changes with aging
Published in Wilbert S. Aronow, Jerome L. Fleg, Michael W. Rich, Tresch and Aronow’s Cardiovascular Disease in the Elderly, 2019
Reduction in the T-wave amplitude with age begins by the fourth decade (140,147). The spatial T-wave vector shifts leftward with age in concert with the leftward shift in QRS axis. Obesity magnifies these changes in the T waves, especially in men (140). Although isolated T wave flattening does not portend excess CV risk, definite T-wave inversion usually occurs in patients with organic heart disease and is associated with increased mortality.
Electrocardiography and arrhythmias
Published in Neil Herring, David J. Paterson, Levick's Introduction to Cardiovascular Physiology, 2018
Neil Herring, David J. Paterson
Ventricular repolarization is slower and less synchronous than depolarization, so it generates a broad, but relatively low-magnitude wave, the T wave (Figure 5.3). The second heart sound follows closely after the T waves. Both the T and R waves are upright in most ECG recordings, even though repolarization is the electrical opposite of depolarization. The explanation of this oddity is deferred to Section 5.5, because it depends on the concept of ‘cardiac dipole' (Section 5.4). Myocardial ischaemia can cause T wave inversion (see Section 5.9 and Figure 5.10).
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
The study population was derived from Zhongnan Hospital of Wuhan University. This retrospective, single-center observational cohort study was conducted from January 2016 to January 2022. General inclusion criteria included patients older than 18 years who were first diagnosed with hypertension according to the 2017 ACC/AHA blood pressure guidelines and were readmitted to the hospital for follow-up(10). Patients with previous cardiovascular and cerebrovascular diseases, a history of malignancy, severe underlying liver and kidney diseases, and insufficient clinical data were not included in the study. Therefore, a total of 430 hypertensive patients were included in this study and divided into abnormal T-wave group and normal T-wave group according to ECG diagnosis (Figure 1). The diagnostic criteria of T-wave abnormalities in this study included T-wave inversion (TWI), T-wave depression (TWD), and other ST-T abnormalities (STT)(5). The primary endpoint was major adverse cardiovascular events (MACE), including non-fatal myocardial infarction, acute coronary syndrome, malignant arrhythmia, acute decompensated heart failure, and death from cardiovascular causes.
Association between Tpeak-Tend/QT and major adverse cardiovascular events in patients with Takotsubo syndrome
Published in Acta Cardiologica, 2021
Annabella Braschi, Arian Frasheri, Renzo M. Lombardo, Maurizio G. Abrignani, Rosalia Lo Presti, Daniele Vinci, Marcello Traina
Considering only ventricular tachyarrhythmias and death and subdividing the study population on the basis of their occurrence, it was found that, the group, in which the aforementioned in-hospital complications occurred, was characterised by older age (75.7 ± 7.5 years versus 65.6 ± 9.8 years) and lower EF (39.0 ± 7.9% versus 46.2 ± 10.5%); however, these differences were not statistically significant (p > 0.05 for both variables). A significantly higher percentage of patients showing T wave inversion in the anterior leads (100% versus 8.5%; p < 0.001) and anterior Q waves (33.3% versus 2.1%; p-value <0.01) was demonstrated. The anterior STE, despite more common in patients with adverse events (66.7% versus 21.3%), did not reach the statistical significance (p = 0.07).
Central Nervous System and Cardiac Involvement in the Hypereosinophilic Syndrome: A Case Report
Published in Immunological Investigations, 2021
Reza Kiani, Batoul Naghavi, Ahmad Amin, Anita Sadeghpour, Ali Zahedmehr, Ata Firouzi, Hamid Reza Pouraliakbar, Saeed Ebrahimi Meymand, Armin Marashizadeh, Simin Almasi
The hypereosinophilic cardiac disease may involve the three cardiac layers, presented from acute myocarditis to endomyocardial fibrosis. The clinical presentation manifested mainly by heart failure and embolic events (Davies et all. 1983; Filippetti et al. 2017). Pericardium predominantly involved as pericardial effusion and tamponade in some cases due to HES (Arvie and Duggal 2009; Kline et al. 2016). In this patient, cardiac tamponade was the first clinical presentation. T wave inversion was the only ECG abnormality in this case. In previous studies, Electrocardiographic abnormalities present only in 1/3 of the patients and T wave inversion is the most common finding on the ECG (Mankad et al. 2016). Other symptoms such as chest pain, palpitations, syncope, and sudden cardiac death were rarely reported in the context of hypereosinophilia (Coelho-Filho et al. 2010; Parrillo et al. 1979).