Giant Inverted T waves in the emergency department: case report and review of differential diagnoses

Abstract Inverted T waves are frequently seen in electrocardiograms (ECGs) and may represent a myriad of pathologies or nonspecific change. However, deep (giant) inverted T waves are only seen in a few clinical conditions. Presence of giant T waves should generally prompt investigations for apical (...

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Bibliographic Details
Published in:Journal of electrocardiology 2010, Vol.43 (1), p.40-42
Main Authors: Pillarisetti, Jayasree, MD, Gupta, Kamal, MD
Format: Article
Language:English
Subjects:
Arrhythmias, Cardiac - diagnosis
Arrhythmias, Cardiac - etiology
Cardiovascular
Diagnosis, Differential
ECG findings
Electrocardiography - methods
Emergency Medical Services - methods
Humans
Hypertrophic cardiomyopathy
Male
Middle Aged
Myocardial Ischemia
Pulmonary embolism
Pulmonary Embolism - complications
Pulmonary Embolism - diagnosis
T-wave inversion
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Description
Summary:Abstract Inverted T waves are frequently seen in electrocardiograms (ECGs) and may represent a myriad of pathologies or nonspecific change. However, deep (giant) inverted T waves are only seen in a few clinical conditions. Presence of giant T waves should generally prompt investigations for apical (Yamaguchi) variant of hypertrophic cardiomyopathy, raised intracranial pressure, severe myocardial ischemia, posttachycardia syndrome, and others. This report describes an unusual case of moderate but not massive pulmonary embolism presenting with an ECG finding of giant inverted T waves. A review of the common conditions associated with such an ECG is also presented.
ISSN:0022-0736
1532-8430
DOI:10.1016/j.jelectrocard.2009.08.048