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The effect of brief hyperventilation on the precordial T waves of 350 normal adults is described. Evidence is presented that brief hyperventilation initiates a vagal reflex which results in the T-wave inversion. Supportive data are also given to exclude respiratory alkalosis as a possible mechanism. Caution is advised in interpreting isolated T-wave inversions as indicative of organic heart disease. It is proposed that isolated T-wave inversion be deleted as a criterion for a "positive" exercise test.

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