"Persistent Juvenile" T-Wave Pattern May Not Be Persistent: Case Series and Literature Review.

Area of Science:

• Cardiology
• Electrocardiography
• Emergency Medicine

Background:

• T-wave inversions (TWI) can indicate serious cardiac conditions or represent benign variants.
• The "persistent" juvenile T-wave pattern (PJTWP) is a recognized benign variant characterized by TWI in the right precordium, thought to be an arrested developmental stage.

Observation:

• A case series of four African-American women (ages 20-43) presented with new-onset right precordial TWI.
• These TWI were absent on previous electrocardiograms (ECGs).
• Diagnostic workup excluded acute cardiopulmonary etiologies for the new TWI.

Findings:

• The study suggests that the "persistent" juvenile T-wave pattern may not always be persistent in an individual.
• New-onset right precordial TWI in young African-American women, after ruling out acute disease, can be consistent with PJTWP.

Implications:

• Emergency physicians should be aware that new right precordial TWI in specific demographics (young, African-American women) might be a benign variant.
• This finding should not automatically exclude the diagnosis of PJTWP, potentially avoiding unnecessary investigations for acute conditions.