Clinical significance of bifid T waves

An attempt was made to analyze bifid T waves which appeared in different clinical conditions. Bifid T waves occurred in 16% of 600 normal children, 92% of 37 cases of childhood ventricular septal defect (VSD), 6 of 10 cases of tetralogy of Fallot (children) and 33% of 193 patients with cerebrovascular accidents (including 3 children). Sixteen cases of bifid T waves which appeared after amiodarone treatment were also analyzed. It was thought that in normal children, bifid T waves might be due to right ventricular preponderance. In VSD, the bifid T waves assumed a peculiar "dome and dart" appearance. In cerebrovascular accidents, autonomic imbalance might be at fault. In cases of treatment with adriamycin, myocardial toxicity is the most probable cause. The conclusion was made that bifid T waves can appear in different clinical settings, which must be considered individually.