" Are these hyperacute T-waves? " - what is your recommendation for the team in these two cases?

Written by Pendell Meyers, edits by Steve SmithWhen practitioners are learning a new ECG concept for the first time, they very appropriately must go through a stage where they titrate their mind to the new finding, going through stages of over and under-recognizing. In my experience this is a normal phenomenon in all of medicine, and especially in ECG interpretation.As I have recently been promoting recognition of hyperacute T waves among my group, I am getting more and more ECGs texted to me very appropriately asking "are these T-waves hyperacute?"So let ' s go over some hyperacute T-waves " ground rules " : - There is no formal, universal definition of what constitutes a hyperacute T-wave. They could likely be defined as an elevation in the ratio of area under the ST-segment and T-wave compared to the area/size of the QRS complex. Although prior groups have described hyperacute T-waves simply as " tall and symmetric " (1), Smith et al showed that among patients with ischemic symptoms and at least 1mm STE in V2-V4, the absolute T-wave amplitude did not differ between patients with subtle LAD OMI and those with normal variant STE ( " early repol " ). When the T-waves in both groups were measured as a ratio of their preceding R-wave, those with subtle LAD OMI had proportionally larger T-waves than those with normal variant STE (T/R ratio = 0.7 for BER vs. 3.1 for LAD OMI) (2). - However, in my experience this is not enough. There is also morphology to consider. Hyper...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs