ECG tutorial: ST and T wave changes Author Philip J Podrid, MD Section Editor Ary L Goldberger, MD Deputy Editor Gordon M Saperia, MD, FACC NONSPECIFIC ST-T WAVE CHANGES — Nonspecific ST-T wave abnormalities are very common and may be seen in any limb or precordial lead of the electrocardiogram. The changes may be seen in all of the limb and precordial leads (diffuse changes), or they may be present only in the inferior, lateral, or anterior leads. The types of abnormalities are varied and include straightening of the ST segment, ST segment depression or elevation, flattening of the T wave, or T wave inversion (show ECG 1). Causes of these changes include: * Electrolyte abnormalities * Post-cardiac surgical state * Anemia * Fever * Acidosis or alkalosis * Catecholamines * Drugs * Acute abdominal process * Endocrine abnormalities * Metabolic changes * Cerebrovascular accidents * Diseases such as myocarditis, pericarditis, cardiomyopathy, pulmonary emboli, infections, amyloidosis, systemic diseases, lung diseases Abnormal T waves and ST segments may also be seen in healthy individuals, including well trained athletes. ST-T WAVE CHANGES ASSOCIATED WITH SPECIFIC DISEASE STATES — Specific patterns of ST-T wave changes may be seen in association with various disease states. Ischemia — ST-T wave abnormalities that are suggestive of subendocardial myocardial ischemia may be present diffusely in many leads; more commonly they are localized to the leads associated with the involved region of the myocardium (show ECG 2). (See quot;Electrocardiogram in the diagnosis of myocardial ischemia and infarctionquot;). Typically there are ST segment changes associated with T wave flattening or inversion; isolated T wave changes are not usually seen with ischemia. What all this means: Both nonspecific ST and T wave changes as well as inverted P waves can be completely normal, or could be a result of such a long list of diseases that you would need to diagnose by other symptoms -- If you don t have any other symptoms, you have nothing to worry about. If there was a real concern, I hope your doc would have mentioned it to you when he gave you these results.
Friday, April 17, 2009
43 years old- new inverted P waves on EKG? -
Had a cath procedure done 1 year ago which was okay everything was clear at that time. Having shortness of breath had EKG done which shows P waves inverted on all leads and a nonspecific ST and T wave abnormality. wondering if this is something to be real concerned about. Have hypertension and bad family history.
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