Global T Wave Inversion

Report:

Sinus rhythm

Normal axis

LVH with ST/T changes ± ischæmia

Comment:

The peculiar thing is that this kind of T wave inversion has a striking preponderance in the elderly woman and is usually not ischæmic, let alone infarctional203. The pattern involves inversion in all the leads except aVR with or without any of the following: (i) V1 upright or inverted; (ii) aVF inverted, while 3 need not be inverted; 1 inverted, aVL need not be inverted.

No evidence of ischaemia or infarction (or new CVA) was associated with this case of global T wave inversion. As usual, it was a non-ischæmic non-event, but almost certainly in a patient with provable (if needs be) IHD.

This patient had a rather nondescript ECG 3 months previously (Fig 272a).

272a.

273. 30 year old man with MOF due to ruptured bowel. The driver of the car that hit him, drunk on the road, thought it was a kangaroo. Adrenaline infusion had been running for over 6 weeks until 3 days prior to this recording. The recording shows his rate and BP response to 100 μg adrenaline IV bolus. The response is unusual. What could explain it?

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