The T wave of the precordial electrocardiogram at different age levels

Suárez, Ramón M.

doi:10.1016/0002-8703(46)90648-5

Cited by 36 publications

(10 citation statements)

References 11 publications

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“…19 However, in some healthy individuals, similar juvenile inverted T waves persist into adulthood. 4 Therefore, incidentally observed T-wave change in an asymptomatic subject poses a clinical problem, because T-wave inversions can also be the expression of an underlying cardiac disease capable of causing sudden cardiac death.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Prognostic Significance of T-Wave Inversions in Right Precordial Leads of a 12-Lead Electrocardiogram in the Middle-Aged Subjects

A¹,

Anttonen²,

Tikkanen³

et al. 2012

Circulation

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Background-T-wave inversion in right precordial leads V 1 to V 3 is a relatively common finding in a 12-lead ECG of children and adolescents and is infrequently found also in healthy adults. However, this ECG pattern can also be the first presentation of arrhythmogenic right ventricular cardiomyopathy. The prevalence and prognostic significance of T-wave inversions in the middle-aged general population are not well known. Methods and Results-We evaluated 12-lead ECGs of 10 899 Finnish middle-aged subjects (52% men, mean age 44Ϯ8.5 years) recorded between 1966 and 1972 for the presence of inverted T waves and followed the subjects for 30Ϯ11 years.Primary end points were all-cause mortality, cardiac mortality, and arrhythmic death. T-wave inversions in right precordial leads V 1 to V 3 were present in 54 (0.5%) of the subjects. In addition, 76 (0.7%) of the subjects had inverted T waves present only in leads other than V 1 to V 3 . Right precordial T-wave inversions did not predict increased mortality (not significant for all end points). However, inverted T waves in leads other than V 1 to V 3 were associated with an increased risk of cardiac and arrhythmic death (PϽ0.001 for both). Conclusions-T-wave inversions in right precordial leads are relatively rare in the general population, and are not associated with adverse outcome. Increased mortality risk associated with inverted T waves in other leads may reflect the presence of an underlying structural heart disease. (Circulation. 2012;125:2572-2577.)

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Section: Discussionmentioning

confidence: 99%

Prevalence and Prognostic Significance of T-Wave Inversions in Right Precordial Leads of a 12-Lead Electrocardiogram in the Middle-Aged Subjects

A¹,

Anttonen²,

Tikkanen³

et al. 2012

Circulation

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“…Suarez and Suarez 3 reported the following prevalence of precordial T-wave inversion in children Ͻ12 years of age: lead V 2 in 45% to 65% of children, lead V 2 to V 3 in 30% to 40%, and beyond lead V 3 in 5% to 20%. In individuals 12 to 18 years of age, the prevalence of T-wave inversion decreased to 10% to 20% in lead V 2 and to 5% in lead V 3 , with no patients showing T-wave inversion beyond lead V 3 . In an older healthy population 19 to 45 years of age, the prevalence of the juvenile pattern of right precordial T-wave inversion was only 13% in lead V 2 and 3% in lead V 3 .…”

Section: T-wave Inversionmentioning

confidence: 90%

“…This ECG pattern, known as persistence of the juvenile pattern of repolarization, is traditionally considered nonspecific and not associated with an increased cardiovascular risk. [3][4][5][6][7] …”

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confidence: 99%

Prevalence of Cardiomyopathy in Italian Asymptomatic Children With Electrocardiographic T-Wave Inversion at Preparticipation Screening

et al. 2012

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Background-T-wave inversion on a 12-lead ECG is usually dismissed in young people as normal persistence of the juvenile pattern of repolarization. However, T-wave inversion is a common ECG abnormality of cardiomyopathies such as hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy, which are leading causes of sudden cardiac death in athletes. We prospectively assessed the prevalence, age relation, and underlying cardiomyopathy of T-wave inversion in children undergoing preparticipation screening. Methods and Results-The study population included 2765 consecutive Italian children (1914 male participants; mean age, 13.9Ϯ2.2 years; range 8 -18 years) undergoing preparticipation screening including an ECG. Of 229 children (8%) who underwent further evaluation because of positive findings at initial preparticipation screening, 33 (1.2%) were diagnosed with cardiovascular disease. T-wave inversion was recorded in 158 children (5.7%) and was localized in the right precordial leads in 131 (4.7%). The prevalence of right precordial T-wave inversion decreased significantly with increasing age (8.4% in children Ͻ14 years of age versus 1.7% in those Ն14 years; PϽ0.001), pubertal development (9.5% of children with incomplete versus 1.6% with complete development; PϽ0.001), and body mass index below the 10th percentile (PϽ0.001). Incomplete pubertal development was the only independent predictor for right precordial T-wave inversion (odds ratio, 3.6; 95% confidence interval, 1.9 -6.8; PϽ0.001). Of 158 children with T-wave inversion, 4 (2.5%) had a diagnosis of cardiomyopathy, including arrhythmogenic right ventricular cardiomyopathy (nϭ3) and hypertrophic cardiomyopathy (nϭ1). Conclusions-The prevalence of T-wave inversion decreases significantly after puberty. Echocardiographic investigation of children with postpubertal persistence of T-wave inversion at preparticipation screening is warranted because it may lead to presymptomatic diagnosis of a cardiomyopathy that could lead to sudden cardiac death during sports. (Circulation. 2012;125:529-538.)

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“…In children the R/S ratio in right chest leads is different from adults, for the R wave is often greater than the S wave in VI or V2 ( Fig. 11 and 12, p. 224), and there may be steep T inversion in these leads (Master, 1937;Suarez, 1946). Left chest leads in children are similar to those in adults.…”

Section: The R Wavementioning

confidence: 93%

The Chest Lead Electrocardiogram in Health

Leatham¹

1950

Heart

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In this investigation 100 healthy adults were personally examined clinically, radiologically, and electrocardiographically. The leads in each subject included standard limb leads and unipolar limb leads (not analysed in this paper), and chest leads in positions 1 to 6 (American Heart Association, 1938) and in position 7 in the posterior axillary line (Evans and Hunter, 1943) The CR and V leads were taken in all subjects, but the CF leads were discontinued after the first 50 (aged 40 to 71 years) because of their variability. The voltage at the chest electrode was usually much higher than at the indifferent electrode, whether CR, V, or even CF was used, so that the pattern of the chest lead electrocardiogram depended more on the position of the chest electrode than on the choice of the indifferent electrode (Wilson, 1937). When the findings were common to CR, V, and CF, the chest leads were referred to as Cl or C2 or C3, etc. Of the 100 healthy adults the majority were males; 50 were between the ages of 18 and 40 years (average 27), and 50 were between 40 and 71 years (average 53). They were without symptoms or abnormal physical signs and the blood pressure was always normal. Fluoroscopy of the heart and chest was normal. The records were always taken on a couch in the semi-recumbent position. The majority of the younger subjects were either medical students, medical officers, or hospital porters. Many of the older group had indigestion, but the pain of coronary artery disease was not simulated; if there was doubt they were excluded. It happened that the subjects were seldom stout, but six women with cyesis were deliberately included. 213 p

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The T wave of the precordial electrocardiogram at different age levels

Cited by 36 publications

References 11 publications

Prevalence and Prognostic Significance of T-Wave Inversions in Right Precordial Leads of a 12-Lead Electrocardiogram in the Middle-Aged Subjects

Prevalence and Prognostic Significance of T-Wave Inversions in Right Precordial Leads of a 12-Lead Electrocardiogram in the Middle-Aged Subjects

Prevalence of Cardiomyopathy in Italian Asymptomatic Children With Electrocardiographic T-Wave Inversion at Preparticipation Screening

The Chest Lead Electrocardiogram in Health

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