Giant wide T inversion – Cardiology MCQ

Giant wide T inversion may be seen in all except: a) After a cardiac arrest b) Subarachnoid hemorrhage c) Hyperkalemia d) Takotsubo cardiomyopathy Correct answer: c) Hyperkalemia Giant T wave inversion can be broad and deep or just deep T inversions. A depth of T wave of 10 mm or above is generally considered as deep T inversion [1]. Giant T wave inversions with depth of 35 mm have also been described in literature [2]. Deep T inversions without gross increase in width can occur in ischemia and hypertrophic cardiomyopathy. In a study involving 864 patients with hypertrophic cardiomyopathy, 15% had giant T wave inversion [3]. While giant T inversions occurred in about one third of patients with apical hypertrophic cardiomyopathy, it was seen in only 6.2% of those with asymmetric septal hypertrophy and one fourth of those with mixed pattern of hypertrophy. But there was no significant correlation between the apical myocardial thickness and the amplitude of T wave inversion. In ischemia the width may sometimes be increased. Absence of left ventricular hypertrophy and symmetric nature of the T inversion (as in the ECG illustrated) has been suggested as indicators of myocardial ischemia in giant T wave inversion [4]. Deep and wide negative T waves are an important feature of post anoxic state and occurs typically after a Stokes-Adam attack. Presence of such broad and negative T waves in a case of complete heart block would indicate that the person had a recent episode of asystol...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance ECG / Electrophysiology Source Type: blogs