[Origin of the deep and wide T-wave in myocardial diseases]

The presented analysis concerns the clinical and electrocardiographic data of dynamic examinations of 15 patients in whom ECG recorded a deep and wide ("gigantic") inverted T-wave. In 5 cases the clinical and electrocardiographic data were compared with the anatomic ones. It was demonstrated that a wide and deep inverted T-wave is common in ischaemic heart disease and inflammatory lesions. Focal myocardial lesions (predominantly in the ventricular septum) combined with atrioventricular conductivity disorders in the His-Purkinje system were found to play a definite role in the genesis of the "gigantic" T-wave. In some cases the wide T-wave may develop due to a fusion of T and U-waves. Patients with such ECG alterations suffer severe rhythm disorders in the form of frequent polytopic extrasystoles, paroxysmal ventricular tachycardia, ventricular fibrillation.