Negative U Waves in Left Circumflex Artery Disease
Report:
Atrial rhythm 47/min
Nonspecific T wave changes & small voltage in frontal leads
Negative U waves consistent with coronary artery disease
Comment:
To tell the truth, the initial report stated âconsistent with LAD artery diseaseâ but I heard before I finished reporting the dayâs ECGs that the patient had his proximal left circumflex artery stented for 90% stenosis. So I amended the record before it went into print. At least I learned something new.
The LAA cannot be reported with ectopic (or paced) atrial rhythms; itâs valid only for sinus rhythm. Atrial rhythm is one of the few causes of inverted P waves in lead 1.
This patientâs U waves persisted over 3 hours (Fig 108a) but resolved after the stenting. Fig 108a. three hours later. Sinus rhythm and much higher voltage (for unknown reason) in the frontal leads. Inverted U waves are still present in V4-6.
109. 64 year old man with history of myocardial infarction five months previously and progressive left venticular failure since, admitted for surgery. What surgery?
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