Nausea, Fatigue, and T-Wave Inversion: An Electrocardiographic Challenge

Area of Science:

• Cardiology
• Clinical Toxicology

Background:

• T-wave inversion on a 12-lead electrocardiogram (ECG) typically suggests myocardial ischemia in adults.
• However, in younger individuals, alternative causes for T-wave inversion are more probable.

Purpose of the Study:

• To highlight lithium intoxication as a potential cause of precordial T-wave inversions in young adults.
• To discuss the broad spectrum of ECG abnormalities associated with lithium toxicity.

Main Methods:

• Case presentation of an 18-year-old woman with depression presenting with nausea, fatigue, and tremulousness.
• Electrocardiogram (ECG) findings revealed precordial T-wave inversions.

Main Results:

• The patient's ECG showed precordial T-wave inversions, prompting further investigation.
• Lithium intoxication can manifest with diverse ECG changes, commonly T-wave inversion and QT prolongation.

Conclusions:

• Lithium toxicity affects ion channels crucial for cardiac action potentials.
• ECG abnormalities in lithium intoxication can mimic other cardiac conditions, necessitating a thorough clinical evaluation.