Cardiovascular Medicine Book




T Wave

Aka: T Wave
  1. Findings: Normal
    1. Upright: I, II, V3, V4, V5, V6
    2. Inverted: aVR, V1
    3. Variable: all other leads
    4. Increased Amplitude: aVL and aVF (if QRS over 5 mm)
    5. Shape: Asymmetrical
      1. An upright T Wave normally rises gradually, and falls with a steeper slope
  2. Findings: T Wave Shape
    1. Smooth: Normal
    2. Notched: Pericarditis
    3. Pointed: Myocardial Infarction
    4. T Wave Alternans
      1. Upright T Wave alternates with inverted T Wave on every other beat
      2. Ominous finding that heralds Cardiac Arrest
  3. Findings: T Wave Height
    1. Normal
      1. Limb leads: <5 mm
      2. Precordial leads: < 10 mm
    2. Tall T Wave Causes
      1. Hyperkalemia
      2. Myocardial Infarction
      3. Myocardial Ischemia
      4. Cerebrovascular Accident
  4. Causes: T Wave Inversion in anterior leads (V1 to V4)
    1. Anterior Myocardial Ischemia
    2. Proximal Left Anterior Descending Occlusion
      1. See Wellen's Syndrome
      2. Deeply inverted T Waves or biphasic T Waves in V2-3
    3. Posterior Myocardial Infarction
    4. Pulmonary Embolism with right heart strain
    5. Neurogenic T Waves
      1. Precedes ischemic cerebrovascular event
    6. Yamaguchi Syndrome
      1. Hypertrophic Cardiomyopathy involving the cardiac apex
    7. References
      1. Majoewsky (2012) EM:RAP 12(1): 12

T wave feature (C0429103)

Concepts Finding (T033)
SnomedCT 142097004, 41011002
English T wave feature, t waves, t wave, T wave (observable entity), T wave, T wave feature (observable entity)
Spanish onda T (entidad observable), onda T
Derived from the NIH UMLS (Unified Medical Language System)

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