V1-V2-V3-V4 T wave inversion: Left or right ventricle?

Antonio Mirijello; Roberto Pola; Luisa Saviano; Raffaele Landolfi

doi:10.1136/bcr-2013-200331

V1-V2-V3-V4 T wave inversion: Left or right ventricle?

Antonio Mirijello, Roberto Pola, Luisa Saviano, Raffaele Landolfi

IRCCS Casa Sollievo della Sofferenza

Research output: Contribution to journal › Article › peer-review

Abstract

An 84-year-old woman, affected by Alzheimer's disease, presented to the emergency department with intense dyspnoea. Since ECG was showing T wave inversion in anterior leads and troponin-T was high, the patient was admitted to our unit with a diagnosis of anterior non-ST elevation myocardial infarction. However, the patient's medical history and a further review of the ECG led us to suspect a pulmonary embolism (PE) as a possible differential clinical diagnosis. We tested this alternative hypothesis: echocardiography as well as contrast-enhanced CT scan confirmed the diagnosis of PE. We describe these misleading ECG findings together with a brief discussion of electrocardiographical changes in pulmonary embolism.

Original language	English
Journal	BMJ Case Reports
DOIs	https://doi.org/10.1136/bcr-2013-200331
Publication status	Published - Oct 9 2013

ASJC Scopus subject areas

Medicine(all)

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title = "V1-V2-V3-V4 T wave inversion: Left or right ventricle?",

abstract = "An 84-year-old woman, affected by Alzheimer's disease, presented to the emergency department with intense dyspnoea. Since ECG was showing T wave inversion in anterior leads and troponin-T was high, the patient was admitted to our unit with a diagnosis of anterior non-ST elevation myocardial infarction. However, the patient's medical history and a further review of the ECG led us to suspect a pulmonary embolism (PE) as a possible differential clinical diagnosis. We tested this alternative hypothesis: echocardiography as well as contrast-enhanced CT scan confirmed the diagnosis of PE. We describe these misleading ECG findings together with a brief discussion of electrocardiographical changes in pulmonary embolism.",

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AU - Mirijello, Antonio

AU - Pola, Roberto

AU - Saviano, Luisa

AU - Landolfi, Raffaele

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