I. 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)

II. 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

III. 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

IV. Causes: T Wave Inversion in anterior leads (V1 to V4)

  1. Anterior Myocardial Ischemia
  2. Proximal Left Anterior Descending Occlusion (Wellens Syndrome)
  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

Images: Related links to external sites (from Google)

Ontology: T wave feature (C0429103)

Concepts Finding (T033)
SnomedCT 142097004, 41011002
Spanish T wave, onda T (entidad observable), onda T
English T wave (observable entity), T wave feature, t waves, t wave, T wave, T wave feature (observable entity)