Inverted t wave

BACKGROUND: We investigated the safety, tolerability, and pharmacokinetics of intravenous recombinant human Neuregulin-1 (rhNRG-1), a DNA recombinant protein for the treatment of chronic heart failure, in healthy Chinese volunteers following single and multiple dose administration. METHODS AND RESULTS: To evaluate the safety and tolerance after single-dosing escalation, 28 subjects were divided into six groups (0.2, 0.4, 0.8, 1.2, 1.6, and 2.4 μg/kg) to receive an intravenous (IV) infusion of rhNRG-1 over 10 min by a randomized, open-label design...

The standard 12-lead electrocardiogram (ECG) represents a cornerstone for the diagnosis and evaluation of hypertrophic cardiomyopathy (HCM), the most common genetically determined heart muscle disease, due to its cost-effectiveness and wide availability. The ECG may surprisingly look normal in 4-6% of adult patients, and in less than 3% of paediatric patients, but it is abnormal in the vast majority of the remaining patients. 'Specific' features comprise pathological Q-waves, deep S-waves in V1-V3, or high R-waves in V4-V6 due to left ventricular hypertrophy with T-wave (TW) depression or negative TWs...

Pseudo-Wellens syndrome refers to any electrocardiogram (ECG) pattern that mimics Wellens syndrome with no critical left anterior descending (LAD) artery-associated coronary artery disease. The present study describes a rare case of pseudo-Wellens syndrome associated with pulmonary embolism. A female patient presented with chest tightness for 72 h. The precordial examination and heart sounds were normal. A mild bilateral lower pitting leg edema with a superficial varicose vein was observed. The levels of C-reactive protein (98...

This case highlights the ECG interpretation in acute coronary syndrome absence from ST - elevation myocardial infarction. A patient with acute chest pain and biphasic T - waves or deep inverted T- waves in V2-V3 is at risk for myocardial infarction. Timely cardiological assessment and coronary angiography is required.

BACKGROUND: Among all fetal heart block patients, > 50% cases are associated with maternal autoimmune diseases, and such patients should receive treatment. However, nearly half of fetal heart block cases involve a mother with negative results following autoimmune antibody screening. A few studies have reported long QT syndrome (LQTS) can also present as a severe fetal bradycardia, which does not respond to fetal treatment. Herein, we reported a rare case of an infant who presented with high-degree autoimmune-mediated fetal atrioventricular block (AVB) with LQTS induced by a novel KCNH2 variant...

We report a rare case of takotsubo cardiomyopathy caused by subacute thyroiditis in a man in his 50s. He went to the doctor with complaints of loss of appetite, diarrhoea, chills and general malaise. He had consciousness disturbance, thyrotoxicosis and thyroid-stimulating hormone (TSH) suppression. Thyroglobulin and C reactive protein levels in the blood were elevated, but TSH receptor antibody, thyroid-stimulating antibody, antithyroglobulin antibody and antithyroid peroxidase antibody were not. We began treatment with prednisolone and propranolol after he was diagnosed with thyroid storm caused by subacute thyroiditis...

BACKGROUND: The point mutation at position 3243 in the mitochondrial MT-TL1 gene (m.3243A > G) is a rare cause of hypertrophic cardiomyopathy (HCM). Information about HCM progression over time and occurrence of different cardiomyopathies in m.3243A > G carriers of the same family is still lacking. CASE SUMMARY: A 48-year-old male patient was admitted to a tertiary care hospital with chest pain and dyspnoea. Bilateral hearing loss required hearing aids at the age of 40...

BACKGROUND: Low-QRS voltages (LQRSV) are an unexpected finding in left ventricular (LV) hypertrophy, i.e, hypertrophic cardiomyopathy (HCM) or athlete's heart. METHODS: Prevalence and clinical correlates of LQRSV were investigated in 197 consecutive HCM patients, aged 58±13 years and comparatively in 771 Olympic athletes, aged 23± 4. Clinical characterization included family/personal history, symptoms, NYHA functional class, ECG pattern, ventricular arrhythmias and cardiac magnetic resonance (CMR)...

BACKGROUND Reversible cerebral vasoconstriction syndrome (RCVS) is a disorder characterized by recurrent thunderclap headaches and reversible cerebral vasoconstriction. CASE REPORT Herein, we present the case of a man in his forties with a disease entity related to RCVS accompanied by vasospasm of the extracerebral blood vessels throughout the body. The patient presented to the Emergency Department with a severe headache and epigastric pain. Initially receiving a misdiagnosis of functional pain, he continued to experience severe recurrent headaches, most often after urinating or defecating and was referred to our department...

STUDY OBJECTIVE: The diagnostic performance of T-wave amplitudes for the detection of myocardial infarction is largely unknown. We aimed to address this knowledge gap. METHODS: T-wave amplitudes were automatically measured in 12-lead ECGs of patients presenting with acute chest discomfort to the emergency department within a prospective diagnostic multicenter study. The final diagnosis was centrally adjudicated by 2 independent cardiologists. Patients with left ventricular hypertrophy, complete left bundle branch block, or paced ventricular depolarization were excluded...

PURPOSE OF REVIEW: Early repolarization syndrome (ERS), once thought to be innocuous, has now been shown to be responsible for ventricular arrythmias and sudden cardiac death occurrence. This review will help the clinician to identify the patients who are most at risk for arrhythmias, so that they can adopt a preventive or secondary treatment approach, either of which is still poorly defined. RECENT FINDINGS: Patients at high risk are found to be particularly young men, with a personal or family history of syncope or sudden death, who have an inferolateral ER on the electrocardiogram, more elevated J-point, longer J-wave duration and wider J angle, a horizontal or descending ST segment, lower T/R ratio, and small and/or inverted waves...

Patients with mitral valve prolapse (MVP) have a heterogeneous clinical spectrum, ranging from benign to severe clinical presentations such as sudden cardiac death (SCD). Some of the markers of "arrhythmic MVP" include inverted/biphasic T-waves, QT prolongation, and polymorphic premature ventricular contractions (PVCs) originating from the left ventricular outflow tract and papillary muscles (PMs). The genesis of arrhythmias in MVP recognizes the combination of the substrate (fibrosis) and the trigger (mechanical stretch)...

Sudden cardiac death (SCD) is a leading cause of death worldwide, and the majority of SCDs are caused by acute ventricular arrhythmias (VAs). Early afterdepolarizations (EADs) are an important trigger of VA under pathological conditions, e.g., inherited or acquired long QT syndrome (LQTS). However, it remains unclear how EAD events at the cellular level are spatially organized at the tissue level to induce and maintain ventricular arrhythmias and whether the spatial-temporal patterns of EADs at the tissue level are associated with abnormal T-wave morphologies that are often observed in LQTS, such as broad-based, notched or bifid; late appearance; and pointed T-waves...

Arrhythmogenic right ventricular cardiomyopathy (ARVC), formerly called arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/ARVC), is a myocardial structural abnormality disease with clinical presentation of cardiac arrhythmia. It is characterized by the replacement of the myocardium with fibrofatty tissue. We present a case of a young male who met two major criteria for definite diagnosis of ARVC: early transition inverted t waves in lead V1-V4 and MRI showed right ventricle (RV) dyskinesia with RV ejection fraction (EF) < 40%, both satisfying the two major criteria of EKG and MRI required for definitive diagnosis...

BACKGROUND: Dextrocardia is a congenital heart malformation with a low incidence that occurs in only 1 in 10,000-12,000 people. Wolff-Parkinson-White (WPW) syndrome is a congenital condition with additional accessory pathways between the atria and the ventricle, which affects up to three in 1,000 people worldwide. Experience of radiofrequency catheter ablation in patients with WPW syndrome and dextrocardia is scarce due to its rare incidence. CASE PRESENTATION: A 39-year-old female was hospitalized due to two episodes of palpitations in the latest 2 months...

This is a case report of an observation of bradycardia and inverted T-waves anteroseptally on the electrocardiogram along with cardiac symptoms, in a previously healthy 35-year-old woman with post-partum pre-eclampsia. Initially, she had no hypertension or proteinuria, which delayed the time of diagnosis. A possible explanation of bradycardia is a baroreceptor-mediated response to hypertension and hypervolaemia. The changes on the electrocardiogram can be explained by pectus excavatum, an enlarged uterus and endothelial dysfunction...

A platform has been developed to study laser-direct-drive energy coupling at the National Ignition Facility (NIF) using a plastic sphere target irradiated in a polar-direct-drive geometry to launch a spherically converging shock wave. To diagnose this system evolution, eight NIF laser beams are directed onto a curved Cu foil to generate Heα line emission at a photon energy of 8.4 keV. These x rays are collected by a 100-ps gated x-ray imager in the opposing port to produce temporally gated radiographs. The platform is capable of acquiring images during and after the laser drive launches the shock wave...

Wellens' syndrome (WS) is a pattern on an electrocardiogram (ECG) characterized by biphasic T waves or deeply inverted T waves in leads V2-V3 with a recent clinical history of angina. Wellens' pattern on the ECG is particular for critical left anterior descending artery (LAD) stenosis. Wellens' sign and WS have been used interchangeably in the literature. However, the typical patterns of ECG changes noted are mostly represented by Wellens' sign. These ECG changes have been crucial in identifying this subset of patients with severe LAD disease...

Background: Obesity is associated with increased all-cause mortality and cardiovascular disease (CVD). An electrocardiogram (ECG) may be used to screen for subtle signs of CVD or altered cardiac morphology in the obese. Methodology: This observational cross-sectional analysed ECG changes in patients with obesity at a tertiary care centre in southern India. Results: One hundred and fifty adult patients with a mean (SD) BMI of 39.9 (6.7) kg/m2 were recruited in the study after excluding those with comorbidities (diabetes mellitus, systemic hypertension) or on chronic medications (ACE inhibitors)...

Background: Patients with apical hypertrophic cardiomyopathy (ApHCM) have marked inverted T-waves that vary over several years. Inverted T-waves in ApHCM are unstable, but it is unclear whether this change is due to coronary artery disease (CAD) or if it is a characteristic of ApHCM itself. We aimed to study the characteristics of inverted T-waves in patients with ApHCM over the course of 24 h to improve the diagnostic indices of ApHCM. Methods: We examined 83 patients with ApHCM and 89 patients with CAD (who served as the control group)...