Hyperacute T waves

Hyperacute T waves are tall, broad based and more symmetrical than normal. There is no absolute size that is too tall to be normal, as it depends on the size of the QRS. It has been suggested that a T:QRS ratio greater than 0.33 in V1-4 is abnormal. A T/R ratio has also been described. T waves in V4-6 should never be taller than the R wave. If in doubt, compare with a previous baseline ECG.

Hyperacute T waves can be the first sign of coronary occlusion. They localise to the affected artery distribution and can have reciprocal changes. They may also occur with Prinzmetal angina, or when the ST segments are on the way back down again after reperfusion.

See also: T and U waves

Can you add to the information on this page?

This ECG Archive is an academic, non-commercial #FOAMed project aiming to crowdsource a free open access database of ECGs and signs. If you include your personal details such as your name you will be attributed for your contribution, unless you tell us that you don't want this to happen. Personal contact details such as email addresses will not be published but may be used to email you in reply. Full project details and participant information available here.

Topics

References

70 ECGs found. Sort by:
TitleDate
ASCDESC
Show:
31030
per page.
Columns: per page.
In the ECGquest archives, this ECG has been tagged with: - Chest pain Anterior ST elevation Hyperacute T waves Acute Anterior MI 12-Lead Dr Smith's ECG Blog CC BY-NC
Anterior STEMI Evolves to de Winter’s T-waves

This ECG is from a middle aged man who presented with chest pain.

This ECG shows anterior ST elevation with hyperacute T waves. The cause was a 100% proximal LAD occlusion.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Hyperacute T waves Acute Anterior MI 12-Lead Dr Smith's ECG Blog CC BY-NC
Anterior STEMI Evolves to de Winter’s T-waves – repeat ECG

This ECG is from a middle aged man who presented with chest pain. This was the repeat ECG 10 min after arrival.

This ECG shows anterior hyperacute T waves. Earlier ST elevation has all but resolved, likely due to transient reperfusion. The cause was a 100% proximal LAD occlusion.

In the ECGquest archives, this ECG has been tagged with: - Hyperacute T waves Inferior ST elevation Lateral ST elevation Acute Inferior MI Right ventricular MI 12-Lead Dr Smith's ECG Blog CC BY-NC
Inferolateral STEMI: is there right ventricular MI also?

This ECG is from a middle aged man who presented with 1 hour of chest pain.

This ECG shows ST elevation in inferior and lateral leads, caused by a proximal RCA occlusion.

In the ECGquest archives, this ECG has been tagged with: - Hyperacute T waves Inferior ST elevation ST elevation in V4R Acute Inferior MI Right ventricular MI Right leads Dr Smith's ECG Blog CC BY-NC
Inferolateral STEMI: is there right ventricular MI also? Right sided ECG

This ECG is from a middle aged man who presented with 1 hour of chest pain. This was a right sided ECG where V1-6 are really V1R to V6R.

This ECG shows ST elevation in inferior and right sided leads, caused by a proximal RCA occlusion.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Incorrect Machine Interpretation Hyperacute T waves Acute Anterior MI 12-Lead Dr Smith's ECG Blog CC BY-NC
A Computer “Normal” ECG. What is the diagnosis?

This ECG is from a patient of unknown age who presented with chest pain.

In the ECGquest archives, this ECG has been tagged with: - Hyperacute T waves Acute Anterior MI 12-Lead Dr Pendell Meyers Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
Was the intern correct?

This ECG is from a man in his 70s who had 2 hours of chest pain that started at rest.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Double speed 50 mm/sec Hyperacute T waves Chest leads Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
Hyperacute T-waves and Concordant ST Elevation seen in PVCs only

This ECG is from a man in his 50s who had chest pain. His only risk factor for ischemia was hypertension.

This ECG shows bigeminy with PVCs showing concordant ST elevation in V2 and hyperacute T waves in V4-6.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Double speed 50 mm/sec Hyperacute T waves ST elevation in a PVC Limb leads Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
Hyperacute T-waves and Concordant ST Elevation seen in PVCs only
In the ECGquest archives, this ECG has been tagged with: - Chest pain Double speed 50 mm/sec Hyperacute T waves Inferior ST depression Acute Anterior MI 12-Lead Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
A 65 year old with chest pain, ECG recorded at 50 mm/sec

This ECG is from a man in his 60s who presented with sudden central chest pressure with nausea. He had a history of previous infarction 15 years ago. This was his initial prehospital ECG.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Double speed 50 mm/sec Anterior ST elevation Hyperacute T waves Inferior ST depression Acute Anterior MI 12-Lead Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
A 65 year old with chest pain, ECG recorded at 50 mm/sec

This ECG is from a man in his 60s who presented with sudden central chest pressure with nausea. He had a history of previous infarction 15 years ago. This was his second ECG, taken 35 min after the first.

1 2 3 4 7