ECG Quest > Shapes > T and U waves > Inverted T waves

Inverted T waves

Inverted T waves are upside-down. They can be normal in children. If abnormal they may be caused by ischemia, infarction, strain patterns, bundle branch blocks or raised intracranial pressure.

T waves may be inverted in III, aVL and/or V1. T waves should not be negative in I, II, V5 and V6. T inversion in V2 is common in young women and normal in 1% of young men <30.

See also: T and U waves

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In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea Inverted T waves Atrial ectopic beat Normal Sinus Rhythm Acute right heart strain Pulmonary embolism 12-Lead Dr Smith's ECG Blog CC BY-NC
An elderly woman transferred to you for chest pain, shortness of breath, and positive troponin – does she need the cath lab now?

This ECG is from an elderly woman who presented with sudden onset shortness of breath after months of inactivity due to a back injury.

This ECG shows sinus tachycardia with large inverted T waves, consistent with right heart strain. The cause was a very large PE.

In the ECGquest archives, this ECG has been tagged with: - Anterior ST depression Inverted T waves R in V1 RVH 12-Lead Dr Smith's ECG Blog CC BY-NC
ST Depression and T-wave inversion in V2 and V3.

This ECG is from a middle aged male dialysis patient who was found disorganised and paranoid.

This ECG shows ST depression and T wave inversion in V2-3 due to right ventricular hypertrophy.

In the ECGquest archives, this ECG has been tagged with: - Bradycardia Vertical axis Inverted T waves Sinus bradycardia 12-Lead ECG of the Week CC-BY-NC-SA
ECG of the Week – 28th January 2019 – Interpretation

This ECG is from a teenage girl who presented with ongoing weight loss (BMI 13) and a known eating disorder.

This ECG shows sinus bradycardia (36) and T wave inversion in V1-2 and aVL.

In the ECGquest archives, this ECG has been tagged with: - Inverted T waves Tall QRS Normal 12-Lead Dr Smith's ECG Blog CC BY-NC
15 yo AAM with ST Elevation and T-wave Inversion. Hypertrophic Cardiomyopathy or Normal (“Variant”)?

This ECG is from a teenage male who presented for a routine sports physical. He is African American.

This ECG shows high voltage with benign T wave inversion. Echocardiography did not show any evidence of HOCM.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Inverted T waves 12-Lead Dr Smith's ECG Blog CC BY-NC
Intermittent increasing exertional chest pain and serial negative troponins

This ECG is from a woman in her 40s who presented with intermittent chest pain on exertion over the past 2 weeks. This was the initial ECG when she was pain free.

This ECG shows an inverted T wave in III with slight ST depression V3-6. Troponins were negative. Repeat ECG showed dynamic ST segments. Angiography showed a 95% stenosis of the distal RCA.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Normal Axis Inverted T waves Tall QRS Normal Sinus Rhythm Normal 12-Lead Paediatric ECG Guru CC-BY-NC-SA
Instructors’ Collection ECG: Normal ECG in Seven-year-old Girl

This ECG is from a young girl with mild chest pain.

This ECG shows normal sinus rhythm with inverted T waves in V1 and a tall QRS complex. This was a normal paediatric ECG.

In the ECGquest archives, this ECG has been tagged with: - Inverted T waves J wave Tall QRS Normal Sinus Rhythm Normal 12-Lead Dr Pendell Meyers Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
Two cases of ST Elevation with Terminal T-wave Inversion – do either, neither, or both need reperfusion?

This ECG is from a teenage male who presented with chest tightness and shortness of breath for 6 hours on a background of asthma.

This ECG shows sinus rhythm with tall QRS and associated repolarisation changes, benign T wave inversion in V3-V6 with J-waves and ST-elevation.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea Bradycardia Normal Axis Regular Inverted T waves 12-Lead ECG of the Week CC-BY-NC-SA
ECG of the Week – 3rd December 2018 – Interpretation

This ECG is from a man in his 50s who had an episode of chest pain and shortness of breath. This ECG was recorded when he was pain free.

This ECG shows sinus bradycardia with T wave inversion in the inferior leads, which was caused by reperfusion of a critical stenosis of the RCA.

In the ECGquest archives, this ECG has been tagged with: - Anterior ST elevation Inverted T waves Normal Sinus Rhythm Old anterior MI 12-Lead Dr Pendell Meyers Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
Two cases of ST Elevation with Terminal T-wave Inversion – do either, neither, or both need reperfusion?

This ECG is from a man of unknown age who had cardiac stents placed 2 months ago.

This ECG shows sinus rhythm with QS-waves and ST elevation in V1-V3, with some terminal T-wave inversion. Serial troponins and angiography was normal.

In the ECGquest archives, this ECG has been tagged with: - Nonspecific baseline artefact Regular Right Axis Deviation Anterior ST depression Inferior ST depression Inverted T waves R in V1 Tall P waves Normal Sinus Rhythm Right atrial enlargement 12-Lead ECG Interpretation CC-BY-NC-SA
ECG Blog #156 (LVH – RVH – LAA – RAA – Strain – Ischemia)
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