BACKGROUND: For many years was considered that negative T wave in ischemic heart disease represents ischemia and for many authors located in subepicardial area. METHODS: We performed a review based in the literature and in the experience of the authors commenting the real significance of the presence of negative T wave in patients with ischemic heart disease. RESULTS: The negative T wave may be of primary or secondary type. Negative T wave observed in ischemic heart disease are of primary origin, therefore not a consequence of abnormal repolarization pattern. The negative T wave of ischemic origin presents the following characteristics: (1) are symmetrical and of variable deepness; (2) present mirror patterns; (3) starts in the second part of repolarization; and (4) may be accompanied by positive or negative U wave. The negative T wave of ischemic origin may be seen in the following clinical settings: (1) postmyocardial infarction due to a window effect of necrotic zone and (2) as a consequence of reperfusion in case of aborted MI when the artery has opened spontaneously, or after fibrinolysis, PCI, or coronary spasm. CONCLUSION: Acute ongoing ischemia do not cause negative T wave. This pattern appears when the ongoing ischemia is vanishing or in the chronic phase. In all these cases the cause of negative T wave is not located in the subepicardial area. Furthermore, positive exercise testing is expressed by ST depression never by isolated negative T wave. There are many circumstances that may present negative T wave outside ischemic heart disease and that have been discussed in this paper.
BACKGROUND: For many years was considered that negative T wave in ischemic heart disease represents ischemia and for many authors located in subepicardial area. METHODS: We performed a review based in the literature and in the experience of the authors commenting the real significance of the presence of negative T wave in patients with ischemic heart disease. RESULTS: The negative T wave may be of primary or secondary type. Negative T wave observed in ischemic heart disease are of primary origin, therefore not a consequence of abnormal repolarization pattern. The negative T wave of ischemic origin presents the following characteristics: (1) are symmetrical and of variable deepness; (2) present mirror patterns; (3) starts in the second part of repolarization; and (4) may be accompanied by positive or negative U wave. The negative T wave of ischemic origin may be seen in the following clinical settings: (1) postmyocardial infarction due to a window effect of necrotic zone and (2) as a consequence of reperfusion in case of aborted MI when the artery has opened spontaneously, or after fibrinolysis, PCI, or coronary spasm. CONCLUSION: Acute ongoing ischemia do not cause negative T wave. This pattern appears when the ongoing ischemia is vanishing or in the chronic phase. In all these cases the cause of negative T wave is not located in the subepicardial area. Furthermore, positive exercise testing is expressed by ST depression never by isolated negative T wave. There are many circumstances that may present negative T wave outside ischemic heart disease and that have been discussed in this paper.
Authors: Martina Perazzolo Marra; Alessandro Zorzi; Francesco Corbetti; Manuel De Lazzari; Federico Migliore; Francesco Tona; Giuseppe Tarantini; Sabino Iliceto; Domenico Corrado Journal: Heart Rhythm Date: 2012-09-11 Impact factor: 6.343
Authors: Geneviève C Digby; Piotr Kukla; Zhong-Qun Zhan; Carlos A Pastore; Ryszard Piotrowicz; Edgardo Schapachnik; Wojciech Zareba; Antonio Bayés de Luna; Piotr Pruszczyk; Adrian M Baranchuk Journal: Ann Noninvasive Electrocardiol Date: 2015-05 Impact factor: 1.468
Authors: Tiia Istolahti; Leo-Pekka Lyytikäinen; Heini Huhtala; Tuomo Nieminen; Mika Kähönen; Terho Lehtimäki; Markku Eskola; Ismo Anttila; Antti Jula; Harri Rissanen; Kjell Nikus; Jussi Hernesniemi Journal: Ann Noninvasive Electrocardiol Date: 2020-09-25 Impact factor: 1.468