inverted T-wave

Etiology

• normal in ECG lead aVR
• hypertrophic cardiomyopathy
  • ECG lead V2-V4
• left ventricular hypertrophy (ST-segment depression & T-wave inversion)
  • R wave in lead aVL is >= 11 mm
• ustable angina & myocardial infarction
  • Wellens' syndrome:
    • anterior T-wave inversions (also lateral biphasic T-waves)
    • dyspnea on exertion & deep, symmetric T-wave inversions in leads V2 & V3 accompanied by a flat ST segment most likely unstable angina
  • leads V1-V3 or V2-V4 dominant R waves & ST segment depression suggests LV posterior wall ischemia
    • obtain ECG with modified leads (ECG lead V7, ECG lead V8)
• hypokalemia
• pulmonary embolism
  • right precordial leads (40%)
• pericarditis
  • T-wave inversion when ST segment returns to baseline
  • normalization of ST, PR & T wave changes occur late
• dextrocardia
• CNS processes
  • increased intracranial pressure
  • stroke
  • meningitis
  • subarachnoid hemorrhage
  • Stokes-Adams attacks
  • heat stroke
  • often deep, diffuse
  • may also see ST segment elevation

More general terms

• ECG T wave