T Waves Flashcards
T waves are expected to be upright in what leads?
Upright in all except aVR and V1
What is normal T wave amplitude?
<5mm in limb leads
<10mm in Precordial leads
What does an upright T wave in V1 indicate?
Upright and large T waves in V1 carry a high likelihood of CAD and when new are an indication of ischemia
How is a T wave inversion in lead III interpreted?
Isolated inversion in III can be a normal variant but is not normal if new
Pathologic T waves are usually symmetric and deep
What is the pediatric pattern of T-wave inversion?
Inverted T’s in the right precordial leads that are asymmetric
Describe persistent juvenile T wave pattern
Usually isolated to V1-3
Shallow T wave inversion
Asymmetric
Young patient, common in afro-Caribbean women
Describe expected T-wave changes in bundle branch blocks
T wave inversions are expected to be discordant from the QRS
LBBB causes inversions in left leads: I aVL, V5-6
RBBB causes inversions in the right precordial leads: V1-3
What does LVH do to T waves?
Causes a left sided strain pattern with inversions in left leads: 1, aVL, V5-6
What does RVH do to T waves?
Causes right-sided strain pattern with inversions in inferior leads and right precordial leads
What does PE do to T waves?
Similar to RVH showing right-sided strain
What are the T waves of hypertrophic cardiomyopathy?
Inverted in all precordial leads
What does raised ICP do to T waves?
Large, wide, and deep symmetrical T’s in precordial leads
“cerebral T waves”
The two main causes of biphasic T’s?
Wellens with acute MI: up then down
Hypokalemia: down then up
What are the T’s of Wellen’s syndrome?
Predominant changes in V2-3
Type A: (25%) biphasic T’s
Type B: (75%) deep inverted symmetric
Tend to evolve from A to B over time
What are the two main causes of camelback humped T’s?
U-waves from hypokalemia
Buried P waves in tachycardia or heart block
