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The two main causes of these waves are myocardial ischemia and hypokalemia. Ischemic T waves rise and then fall below the cardiac resting membrane potential; Hypokalemic T waves fall and then rise above the cardiac resting membrane potential; Wellens' Syndrome is a pattern of biphasic T waves in V2–3. It is generally present in patients with ...
Wellens' syndrome is an electrocardiographic manifestation of critical proximal left anterior descending (LAD) coronary artery stenosis in people with unstable angina. ...
In electrocardiography, a strain pattern is a well-recognized marker for the presence of anatomic left ventricular hypertrophy (LVH) in the form of ST depression and T wave inversion on a resting ECG. [1] It is an abnormality of repolarization and it has been associated with an adverse prognosis in a variety heart disease patients.
The earliest sign is hyperacute T waves, peaked T waves due to local hyperkalemia in ischemic myocardium. This then progresses over a period of minutes to elevations of the ST segment by at least 1 mm. Over a period of hours, a pathologic Q wave may appear and the T wave will invert. Over a period of days the ST elevation will resolve.
Risk factors are similar to other types of ischemic heart disease. [1] The underlying mechanism is unclear; though may involve subendocardial ischemia or collateral circulation. [1] Diagnosis is based on an ECG showing ST-segment depression at the J-point of 1 to 3 mm in leads V1 to V6, with tall and symmetrical T waves. [1]
Hyperacute T waves need to be distinguished from the peaked T waves associated with hyperkalemia. [16] In the first few hours the ST segments usually begin to rise. [17] Pathological Q waves may appear within hours or may take greater than 24 hr. [17] The T wave will generally become inverted in the first 24 hours, as the ST elevation begins to ...
It can be difficult to distinguish unstable angina from non-ST elevation (non-Q wave) myocardial infarction. [4] [5] They differ primarily in whether the ischemia is severe enough to cause sufficient damage to the heart's muscular cells to release detectable quantities of a marker of injury, typically troponin T or troponin I.
There must be a prolonged S wave in leads I and V 6 (sometimes referred to as a "slurred" S wave). The T wave should be deflected opposite the terminal deflection of the QRS complex. This is known as appropriate T wave discordance with bundle branch block. A concordant T wave may suggest ischemia or myocardial infarction. [citation needed]