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Loss of precordial T-wave balance occurs when the upright T wave is larger than that in V6. This is a type of hyperacute T wave. The normal T wave in V1 is inverted. An upright T wave in V1 is considered abnormal — especially if it is tall (TTV1), and especially if it is new (NTTV1).
T-wave inversion means that the T-wave is negative. The T-wave is negative if its terminal portion is below the baseline, regardless of whether its other parts are above the baseline. T-wave inversions are frequently misunderstood, particularly in the setting of ischemia.
T wave inversion (TWI) beyond V2 in Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) is common and considered a major diagnostic criterion; on the other hand, the available studies suggest that myocardial pathology is very uncommon in people with TWI in V2–V3.
Primary T-wave inversions are associated with benign syndromes, such as the persistent juvenile T-wave pattern and the digitalis effect, as well as morbid conditions, including acute coronary ischemic events and CNS catastrophe.
This activity reviews the definition of an electrocardiographic T wave, explains how different clinical states can cause changes to T wave morphology, and highlights the role of educating interprofessional team members on the significance of T wave changes to improve patient care.
T-wave inversion means that the T-wave is negative. By definition, the T-wave is negative if the terminal portion of the T-wave is below the baseline. T-wave inversions are actually graded according to the amplitude (depth).
The types of abnormalities are varied and include subtle straightening of the ST segment, actual ST-segment depression or elevation, flattening of the T wave, biphasic T waves, or T-wave inversion (waveform 1).