Transient peaked T waves during exercise stress testing: an unusual manifestation of reversible cardiac ischemia

Exercise-related QT interval shortening with a peaked T wave in a boy with MEN 2 syndrome

“…Electrocardiogram showing prominent peaked T waves with shortening of QT interval at second minute of the early recovery phase. relatively few studies that have analyzed the T-wave changes that may occur with stress testing [4][5][6]. An exercise-associated increased T-wave amplitude has been found to be associated with reversible ischemia in the absence of ST-segment depression [4,5].…”

“…relatively few studies that have analyzed the T-wave changes that may occur with stress testing [4][5][6]. An exercise-associated increased T-wave amplitude has been found to be associated with reversible ischemia in the absence of ST-segment depression [4,5]. Ellestad observed peaked T waves in the precordial leads during treadmill exercise testing in a patient who had an anterior wall acute myocardial infarction several days later [7].…”

“…Ellestad observed peaked T waves in the precordial leads during treadmill exercise testing in a patient who had an anterior wall acute myocardial infarction several days later [7]. Madias and Manankil reported that peaking of the giant T waves in precordial leads during the exercise stress test is associated with significant stenosis of the left anterior descending artery; and speculated that the mechanism of this observation may be extrapolated from the finding of hyperacute T waves seen in the earliest stage of an evolving transmural infarct [4,5]. The mechanism of these electrocardiographic changes in PCC are probably related to acute and massive catecholamine release, causing a direct toxic effect on myocytes [8].…”

Intraprocedural Assessment of Stimulation, Sensing, Detection, and Defibrillation

“…[97][98][99][100] Prominent T waves are also seen with acute myocardial infarction, subarachnoid hemorrhage, ventricular hypertrophy, and early repolarization (Fig. [101][102][103][104][105] Prominent U waves can also lead to oversensing at times and is usually observed in the setting of significant hypokalemia, hyperthyroidism, and certain drug overdoses. [101][102][103][104][105] Prominent U waves can also lead to oversensing at times and is usually observed in the setting of significant hypokalemia, hyperthyroidism, and certain drug overdoses.…”