What Are These Anterior T Waves?: A High-Risk Ischemic Pattern That Should Be Recognized

Area of Science:

• Cardiology
• Electrocardiography
• Internal Medicine

Background:

• Intermittent chest pain can signify underlying cardiac issues.
• Electrocardiography (ECG) is crucial for diagnosing acute coronary syndromes.
• Certain ECG patterns, like Wellens syndrome, predict significant myocardial infarction.

Purpose of the Study:

• To describe a lesser-known ECG pattern associated with high risk of extensive myocardial infarction.
• To highlight the clinical significance of this pattern, comparing it to Wellens syndrome.
• To provide recognition features for this ischemic ECG pattern.

Main Methods:

• Case presentation of an 80-year-old woman with chest pain.
• Performance of a 12-lead ECG during an asymptomatic period.
• Analysis of ECG findings, specifically T wave morphology in leads V1-V3.

Main Results:

• The patient presented with a self-limited episode of chest pain.
• An ECG performed while asymptomatic revealed prominent T waves in leads V1-V3.
• This ECG pattern is proposed as a marker for high-risk myocardial infarction.

Conclusions:

• A specific ECG pattern, characterized by large T waves in V1-V3 in asymptomatic patients, can indicate significant myocardial infarction risk.
• This finding offers a distinct perspective on ischemic ECG patterns, similar in clinical implication to Wellens syndrome.
• Early recognition of this pattern is vital for timely intervention and management of potential cardiac complications.