Electrocardiographic T-wave changes underlying acute cardiac and cerebral events - 15/08/11
, Perwaiz M. Meraj, MD, Shuyi Zheng, MD, Gregory Bloom, MD, Marie Roethel, MD, Amgad N. Makaryus, MDAbstract |
T-wave inversions produced by myocardial infarction (MI) are classically narrow and symmetric. Electrocardiography T-wave changes including low-amplitude and abnormally inverted T waves may be the result of noncardiac path physiology. We present a series of cases that presented with different electrocardiography T-wave changes. The first case involved a 64-year-old woman who presented to the emergency department with diffuse splayed T-wave inversions and was found to have an MI in the context of an acute cerebrovascular accident. We contrasted this case with that of a 76-year-old man with hypercholesterolemia who presented with T-wave widening and a prolonged QT interval and was found to have a subarachnoid hemorrhage secondary to a basilar aneurysm and no MI. Several mechanisms have been suggested to explain the cardiac and cerebral injury, including microvascular spasm and increased levels of circulating catecholamines. Accurate interpretation of T-wave changes can assist the clinician toward a timely therapeutic intervention and accurate diagnosis.
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Vol 26 - N° 6
P. 716-720 - juillet 2008 Retour au numéro
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