Negative T Wave in Ischemic Heart Disease: A Consensus Article
| Autor: | Miquel Fiol, Hein J.J. Wellens, Diego Goldwasser, Antonio Bayés de Luna, Yochai Birnbaum, Ryszard Piotrowicz, Guenter Breithardt, Rafael Baranowski, Kjell Nikus, Wojciech Zareba, Paul Kligfield |
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| Rok vydání: | 2014 |
| Předmět: |
ST depression
medicine.medical_specialty medicine.diagnostic_test business.industry medicine.medical_treatment Ischemia Infarction General Medicine medicine.disease medicine.anatomical_structure Physiology (medical) U wave Internal medicine Fibrinolysis Cardiology Medicine Repolarization medicine.symptom Cardiology and Cardiovascular Medicine business Electrocardiography Artery |
| Zdroj: | Annals of Noninvasive Electrocardiology. 19:426-441 |
| ISSN: | 1082-720X |
| DOI: | 10.1111/anec.12193 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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