Document Detail

Pattern of crescendo TWA may disclose the underlying cardiac pathology.
MedLine Citation:
PMID:  20413129     Owner:  NLM     Status:  MEDLINE    
We present an exercise test case in which crescendo TWA preceded ventricular tachycardia (VT). The patient was examined due to suspicion of ischemic heart disease. The ST-segment became elevated simultaneously with a distinct alternation in the ST-segment and the first half of the T-wave, and the patient developed polymorphic VT. Coronary angiography disclosed marked stenoses. Earlier reports of TWA in patients with congenital long QT syndrome show a pattern in which the T wave frequently alternates above and below the isoelectric line without concomitant ST-segment changes. In Brugada syndrome patients, the signature ST-T wave pattern is the locus of alternation. Future investigation should elucidate whether specific TWA morphologies may expose underlying heart disease.
Tuomo Nieminen; Richard L Verrier; Kjell Nikus; Jari Viik; Rami Lehtinen; Terho Lehtimäki; Willi Kaiser; Mika Kähönen
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-04-22
Journal Detail:
Title:  Journal of electrocardiology     Volume:  43     ISSN:  1532-8430     ISO Abbreviation:  J Electrocardiol     Publication Date:    2010 Sep-Oct
Date Detail:
Created Date:  2010-08-23     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  449-51     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
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MeSH Terms
Coronary Angiography
Coronary Stenosis / diagnosis,  physiopathology*,  surgery
Diagnosis, Differential
Exercise Test
Heart Conduction System / physiopathology*
Middle Aged
Tachycardia, Ventricular / diagnosis,  physiopathology*,  surgery

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