Giant Precordial T Wave Inversion in a Patient with Gastroenteritis

Giant precordial T wave inversion (GPTI) on ECG may be the result of several pathologies, including myocardial ischemia, pulmonary edema, pulmonary embolism, subarachnoid hemorrhage, apical hypertrophy, and postpacing. We describe a case of a 75-year-old woman who developed GPTI after an episode of gastroenteritis. To our knowledge, this is the first report of this ECG pattern associated with gastroenteritis.

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Apical hypertrophy associated with rapid T wave inversion on the electrocardiogram

Heart and Vessels ◽

10.1007/bf01744991 ◽

1995 ◽

Vol 10 (4) ◽

pp. 221-224 ◽

Cited By ~ 5

Author(s):

Hiroshi Yamanari ◽

Daiji Saito ◽

Kakishita Mikio ◽

Kazufumi Nakamura ◽

Tsunetoyo Nanba ◽

...

Keyword(s):

T Wave ◽

Wave Inversion ◽

Apical Hypertrophy

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Late T-wave inversion following resolution of non-ischemic acute pulmonary edema

Clinical Case Reports ◽

10.1002/ccr3.1899 ◽

2018 ◽

Vol 7 (1) ◽

pp. 224-226

Author(s):

Konstantinos Tampakis ◽

Nikolaos Makris ◽

Christos Kontogiannis ◽

Michael Spartalis ◽

Evangelos Repasos ◽

...

Keyword(s):

Pulmonary Edema ◽

Acute Pulmonary Edema ◽

T Wave ◽

Wave Inversion

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T-wave inversion in the precordial leads: сardiac and non-cardiac causes

Kardiologiia ◽

10.18087/cardio.2020.5.n668 ◽

2020 ◽

Vol 60 (5) ◽

pp. 136-145

Author(s):

I. R. Tsoy ◽

I. P. Kolos

Keyword(s):

Pulmonary Embolism ◽

Differential Diagnosis ◽

Anterior Wall ◽

Left Ventricular ◽

Arrhythmogenic Cardiomyopathy ◽

Cardiac Memory ◽

T Wave ◽

Wave Inversion ◽

Threatening Condition ◽

Life Threatening

The T-wave inversion (TWI) is a common electrocardiographic finding. Causes for TWI are numerous and sometimes TWI may appear in life-threatening conditions. The aim of this review was to provide an up-to-date analysis of TWI, including i) definition and prevalence; ii) causes, and iii) differential diagnosis in benign TWI, reversible myocardial ischemia of the left ventricular anterior wall; takotsubo cardiomyopathy; subarachnoid hemorrhage; pulmonary embolism; right ventricular arrhythmogenic cardiomyopathy; and “cardiac memory”. The review presents practical electrophysiological criteria, which allow suspecting in time a life-threatening condition to choose an up-to-date treatment.

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T Wave Inversion Localized To Lead V3 Only With Positive T Wave In Leads V2 And V4 - A Technical Error

10.37191/mapsci-jccr-1(2)-013 ◽

2020 ◽

Author(s):

Sitaram Mittal

Keyword(s):

Myocardial Ischemia ◽

Technical Error ◽

The Past ◽

T Wave ◽

Wave Inversion

T- wave inversion in electrocardiogram immediately attracts attention because myocardial ischemia is a common and serious cause. There are, however, several other, relatively benign, cause that can also cause inversion of T wave. We observed that medial placement of lead V3 electrode can result in false shallow T wave inversion in lead V3. Upright T wave in lead V2 and V4 should give a clue to this technical error. To the best of our knowledge, this cause of T wave inversion localized to lead V3 only with positive T wave in leads V2and V4has not been reported in the past.

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Acute pulmonary embolism as the cause of global T wave inversion and QT prolongation

Journal of Electrocardiology ◽

10.1016/0022-0736(93)90070-t ◽

1993 ◽

Vol 26 (1) ◽

pp. 91-95 ◽

Cited By ~ 26

Author(s):

Charles Y. Lui

Keyword(s):

Pulmonary Embolism ◽

Acute Pulmonary Embolism ◽

Qt Prolongation ◽

T Wave ◽

Wave Inversion

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Pneumopericardium after Laparoscopic Hernia Repair Presents with ST-segment Changes: A Case Report

Clinical Practice and Cases in Emergency Medicine ◽

10.5811/cpcem.2021.2.51069 ◽

2021 ◽

Vol 2 (5) ◽

pp. 178-181

Author(s):

Demi Galindo ◽

Emily Martin ◽

Douglas Franzen

Keyword(s):

Pulmonary Embolism ◽

Case Report ◽

Chest Pain ◽

Myocardial Ischemia ◽

Hernia Repair ◽

Laparoscopic Hernia Repair ◽

T Wave ◽

St Segment ◽

Electrocardiogram Ecg ◽

Unnecessary Intervention

Introduction: Although rare, iatrogenic cases of pneumopericardium have been documented following laparoscopic surgery and mechanical ventilation. Electrocardiogram (ECG) changes, including ST-segment depressions and T-wave inversions, have been documented in cases of pneumopericardium, and can mimic more concerning causes of chest pain including myocardial ischemia or pulmonary embolism. Case Report: This unique case describes a patient who presented with chest pain and ST-segment changes on ECG hours after a laparoscopic inguinal hernia repair and who was found to have pneumopericardium. Conclusion: While iatrogenic pneumopericardium is often self-limiting and rarely requires intervention, it is critical to differentiate pneumopericardium from other etiologies of chest pain, including myocardial ischemia and pulmonary embolism, to prevent unnecessary intervention.

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Massive pulmonary embolism causing large T-wave inversion and QT prolongation

Journal of Thoracic Disease ◽

10.21037/jtd.2017.10.89 ◽

2017 ◽

Vol 9 (11) ◽

pp. 4671-4673 ◽

Cited By ~ 1

Author(s):

János Tomcsányi ◽

Nóra Turi-Kováts ◽

András Wettstein ◽

Hrisula Arabadzisz

Keyword(s):

Pulmonary Embolism ◽

Massive Pulmonary Embolism ◽

Qt Prolongation ◽

T Wave ◽

Wave Inversion

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Diagnostic comparison of anterior leads T-wave inversion and McGinn-White sign in suspected acute pulmonary embolism: A systematic review and meta-analysis

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907920966520 ◽

2020 ◽

pp. 102490792096652

Author(s):

Andrea Laurentius ◽

Rina Ariani

Keyword(s):

Systematic Review ◽

Pulmonary Embolism ◽

Acute Pulmonary Embolism ◽

Diagnostic Value ◽

Youden Index ◽

Sensitivity Index ◽

Diagnostic Study ◽

Accuracy Index ◽

T Wave ◽

Wave Inversion

Introduction: Acute pulmonary embolism is the leading cause of cardiovascular mortality in which only 7% of total suspected cases were correctly diagnosed. Prompt diagnosis is essential to reduce disease burden. 12-lead electrocardiography has become standard of examination in any acute cardiovascular setting. Several abnormalities associated with right ventricular dysfunction include the classic McGinn-White and anterior leads T-wave inversion pattern due to conduction abnormalities. Nevertheless, studies conducting research in evaluating diagnostic values of both patterns have not come to definite conclusion. This review evaluates the diagnostic value of T-wave inversions in anterior leads difference compared to that of McGinn-White sign in patients with suspected acute pulmonary embolism. Methods: Literature searching was conducted from medical databases. Inclusion-exclusion criteria and study eligibility were assessed to select the included studies in this systematic review. Three final articles were selected and critically appraised using the Oxford Center of Evidence-Based Medicine appraisal tools for diagnostic study. Results: Considering the compared importance of selected studies, T-wave inversion shows better specificity (90.9% vs 88.7%) and sensitivity (35.5% vs 28.9%) although both signs exhibit minor impact in terms of sensitivity index. Analyses suggest higher averaged accuracy (accuracy index) and Youden index found in T-wave inversion than that of McGinn-White sign (accuracy index: 57.97% vs 56.16%; Youden index: 0.16 vs 0.12), providing more meaningful diagnostic value. Furthermore, anterior leads T-wave inversion possesses better diagnostic odds ratio than that of McGinn-White sign (5.52 vs 3.17). Conclusion: Anterior lead T-wave inversions present better diagnostic value than that of classic pattern of McGinn-White sign in electrocardiographic presentation of suspected acute pulmonary embolism.

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