Document Detail

Negative T wave in ischemic heart disease: a consensus article.
MedLine Citation:
PMID:  25262662     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: For many years was considered that negative T wave in ischemic heart disease represents ischemia and for many authors located in subepicardial area.
METHODS: We performed a review based in the literature and in the experience of the authors commenting the real significance of the presence of negative T wave in patients with ischemic heart disease.
RESULTS: The negative T wave may be of primary or secondary type. Negative T wave observed in ischemic heart disease are of primary origin, therefore not a consequence of abnormal repolarization pattern. The negative T wave of ischemic origin presents the following characteristics: (1) are symmetrical and of variable deepness; (2) present mirror patterns; (3) starts in the second part of repolarization; and (4) may be accompanied by positive or negative U wave. The negative T wave of ischemic origin may be seen in the following clinical settings: (1) postmyocardial infarction due to a window effect of necrotic zone and (2) as a consequence of reperfusion in case of aborted MI when the artery has opened spontaneously, or after fibrinolysis, PCI, or coronary spasm.
CONCLUSION: Acute ongoing ischemia do not cause negative T wave. This pattern appears when the ongoing ischemia is vanishing or in the chronic phase. In all these cases the cause of negative T wave is not located in the subepicardial area. Furthermore, positive exercise testing is expressed by ST depression never by isolated negative T wave. There are many circumstances that may present negative T wave outside ischemic heart disease and that have been discussed in this paper.
Antonio Bayés de Luna; Wojciech Zareba; Miquel Fiol; Kjell Nikus; Yochai Birnbaum; Rafael Baranowski; Diego Goldwasser; Paul Kligfield; Ryszard Piotrowicz; Günter Breithardt; Hein Wellens
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc     Volume:  19     ISSN:  1542-474X     ISO Abbreviation:  Ann Noninvasive Electrocardiol     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-09-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607443     Medline TA:  Ann Noninvasive Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  426-41     Citation Subset:  IM    
Copyright Information:
© 2014 Wiley Periodicals, Inc.
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