Complete Causes Of T-Wave Abnormality

Complete Causes Of T-Wave Abnormality

T-wave is a wave that occurs on the electrocardiogram (ECG). ECG is a tracing of the electrical activity of heart. The normal waves that an ECG shows are P-wave, QRS complex, and T-wave. T-wave abnormality is the commonest ECG abnormality, occurring in 2.5% of all ECGs recorded and in 50% of abnormal ECGs recorded. T-wave abnormalities should not be interpreted without correlation with clinical and other laboratory findings. T-wave changes may also be noted in some otherwise healthy individuals.

Normal T-wave is both inverted and upright, depending on the section of the ECG or the particular electrical lead responsible for the tracing. The abnormalities of the T-wave (keeping in mind the section of the ECG being seen) can be taller than normal waves, inverted waves, biphasic waves, ‘camel hump’ waves, and flattened waves. Abnormalities of T-wave can occur both in illnesses related to heart and illnesses unrelated to heart. Here are some of the causes.


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Causes of T-Wave Abnormality

Brain Hemorrhage

Brain hemorrhage (bleeding) can cause a sudden rise in the intracranial pressure. This can cause T-waves that are inverted and bizarre in shape. Brain hemorrhage can occur due to head injury, hypertension, arterial aneurysm, or brain tumor. Other risk factors for brain hemorrhage are diabetes, smoking, and consuming two or more alcoholic drinks per day.

Brain Hemmorage

Myocardial Ischemia and Infarction (Angina and Heart Attack)

T wave inversion (could be normal in lead III) can occur in angina or heart attack. If the inversion is a new one (in comparison to previous ECGs), it is calways pathological. Pathological inverted T waves are deep and symmetrical. Sometimes there can be flattened T-waves or biphasic T-waves. The typical preceding symptom is chest pain. The T wave inversion occurs in those leads corresponding to the area of ischemia or infarction.

Heart attack

Bundle Branch Block

Bundle branch block is a defect or block in the heart’s conduction system that relays electrical impulses from the point of their origin to the rest of the heart. There can be T-wave inversion in bundle branch block. Bundle branch block can occur due to an underlying heart disease, heart attack, and surgery done on the heart.

Heart Valve Disease

Pulmonary Embolism

Pulmonary embolism is the blockage of a main artery of lung due to an embolus (substance, usually a clot, travelling in the blood). It causes T-wave inversion. The symptoms of pulmonary embolism are breathlessness, rapid breathing, cough, blood in sputum, and chest pain. A risk factor for pulmonary embolism is deep vein thrombosis in the legs.

Pulmonary Embolism

Ventricular Hypertrophy

Ventricles are the lower chambers of the heart. Their hypertrophy (thickening of the walls), as in heart failure or after heart attack, can lead to abnormal inverted T-waves. Ventricular hypertrophy can occur in varied settings such as hypertension (high blood pressure), injury to heart muscle (due to heart attack), heart failure, valvular heart disease, hypertrophic cardiomyopathy, and due to certain neurohormones.

Ventricular HypertrophySymptoms of ventricular hypertrophy can be shortness of breath, sensory awareness of heartbeats (palpitations), dizziness or fainting, and chest pain. Ventricular hypertrophy can also occur as an adaptive response to exercise, particularly anaerobic exercise like lifting weights.

Hypokalemia and Hyperkalemia

Hypokalemia, or decrease in the concentration of potassium in the blood, causes flattened T-waves and sometimes inverted T-waves and T-waves with double peak. Hypokalemia can occur due to inadequate dietary intake, diarrhea, vomiting, surgery, excessive sweating, intake of certain diuretics, and as a complication of diabetes.

Hypokalemia and Hyperkalemia Due To SurgeryHyperkalemia, or increase in concentration of potassium in the blood, causes tall and narrow T-waves. Hyperkalemia can occur due to excessive intake, impaired functioning of kidneys, certain medications, hormonal imbalance, breakdown of muscle tissue, and burns.

Other Causes

T-wave inversion can occur in healthy individuals after eating, after drinking cold water, and after hyperventilation. Anxiety, fear and nervousness can cause T-wave abnormalities, which become normal after reassurance and rest. Impaired functioning of the endocrine glands thyroid, adrenals, and pituitary can cause T-wave abnormalities.

anxiety disorder

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