Hyperacute T wave, the early sign of myocardial infarction

Sovari, Ali A.; Assadi, Ramin; Lakshminarayanan, Bataulatundu; Kocheril, Abraham G.

doi:10.1016/j.ajem.2007.02.005

Cited by 10 publications

(5 citation statements)

References 16 publications

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“…Post resuscitation in the ER, a second ECG showed diffuse T wave peaking and an incomplete right bundle branch block. These findings were also attributed as representative of an acute myocardial infarction as they were similar in nature to the hyper-acute T waves sometimes seen preceding STEMIs [ 10 ]. However, with resolution of ST segment elevation associated with an acute MI, the T wave in general normalizes or inverts [ 11 ]; acute peaking would only be representative of another factor such as hyperkalemia or acute pericarditis.…”

Section: Discussionmentioning

confidence: 93%

Hyperkalemia masked by pseudo-stemi infarct pattern and cardiac arrest

et al. 2017

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BackgroundHyperkalemia is a common electrolyte abnormality and has well-recognized early electrocardiographic manifestations including PR prolongation and symmetric T wave peaking. With severe increase in serum potassium, dysrhythmias and atrioventricular and bundle branch blocks can be seen on electrocardiogram. Although cardiac arrest is a worrisome consequence of untreated hyperkalemia, rarely does hyperkalemia electrocardiographically manifest as acute ischemia.Case presentationWe present a case of acute renal failure complicated by malignant hyperkalemia and eventual ventricular fibrillation cardiac arrest. Recognition of this disorder was delayed secondary to an initial ECG pattern suggesting an acute ST segment elevation myocardial infarction (STEMI). Emergent coronary angiography performed showed no evidence of coronary artery disease.ConclusionsPseudo-STEMI patterns are rarely seen in association with acute hyperkalemia and are most commonly described with patient without acute cardiac symptomatology. This is the first such case presenting concurrently with cardiac arrest. A brief review of this rare pseudo-infarct pattern is also given.

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Section: Discussionmentioning

confidence: 93%

Hyperkalemia masked by pseudo-stemi infarct pattern and cardiac arrest

et al. 2017

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“…21 Patients who present very early after acute occlusion of a coronary artery may not yet display ST segment elevation, but rather prominent T waves, often termed hyperacute T waves. 22,23 This has been described in the literature in human subjects as early as 1934. 24 In a subgroup study of one of the early thrombolytic trials, higher T waves were observed more frequently in patients with a shorter duration of symptoms (2.5 vs 3.3 hours).…”

Section: Clinical Findings Electrocardiogrammentioning

confidence: 92%

Chest Pain Evaluation in the Emergency Department

Foy

Filippone

2015

Medical Clinics of North America

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“…Hyperacute T waves have commonly been associated with ST-segment elevation myocardial infarction [8], left ventricular hypertrophy, acute myocarditis, acute pericarditis, and hyperkalemia [9] [10]. Not all hyperacute T waves are pathological or indicative of ischemic pathogenesis or hyperkalemia, they are benign in the early phases of repolarization [11].…”

Section: Discussionmentioning

confidence: 99%

Isolated Hyperacute T-Waves in West Nile Encephalitis Indicating Atypical Variant of Stress-Induced Cardiomyopathy

Rafique,

Khan,

Siddique

2024

JBM

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Several cardiac outcomes have been reported with West Nile-encephalitis; however, the underlying pathophysiology remains complex. We present a 42-year-old female, with multiple sclerosis, whose neurological symptoms and respiratory decline were finally explained by the diagnosis of West Nile-encephalitis. During her admission, the isolated peaked T-waves indicated the underlying stress-induced cardiomyopathy. The absence of all other causes of hyperacute T-waves, their subsequent resolution with the resolution of infection and improvement in wall motion abnormalities, further supported the association. This case highlights the importance of considering hyperacute T-waves in an approach towards the diagnosis of WNV-encephalitis related atypical variant of stress-induced cardiomyopathy.

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Hyperacute T wave, the early sign of myocardial infarction

Cited by 10 publications

References 16 publications

Hyperkalemia masked by pseudo-stemi infarct pattern and cardiac arrest

Hyperkalemia masked by pseudo-stemi infarct pattern and cardiac arrest

Chest Pain Evaluation in the Emergency Department

Isolated Hyperacute T-Waves in West Nile Encephalitis Indicating Atypical Variant of Stress-Induced Cardiomyopathy

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