Amal Mattu’s ECG Case of the Week – March 30, 2015 To view the remainder of this post you must be logged in or have an annual account. Log In Click here to purchase an annual account By ECGWeekly Support|2016-12-21T17:14:57-05:00March 30th, 2015|9 Comments Share This Story, Choose Your Platform! FacebookTwitterLinkedInTumblrPinterestEmail Related Posts Amal Mattu’s ECG Case of the Week – March 30, 2020 Gallery Amal Mattu’s ECG Case of the Week – March 30, 2020 Amal Mattu’s ECG Case of the Week – March 23, 2020 Gallery Amal Mattu’s ECG Case of the Week – March 23, 2020 Amal Mattu’s ECG Case of the Week – March 16, 2020 Gallery Amal Mattu’s ECG Case of the Week – March 16, 2020 Amal Mattu’s ECG Case of the Week – March 9, 2020 Gallery Amal Mattu’s ECG Case of the Week – March 9, 2020 Amal Mattu’s ECG Case of the Week – March 2, 2020 Gallery Amal Mattu’s ECG Case of the Week – March 2, 2020 9 Comments AHMED FALIH H March 30, 2015 at 7:20 amLog in to Reply Thanks dr.great case ,and what about T wave inversion in lead AVL does it represent an early reciprocal changes for inferior MI? Thanks again HECTOR M March 30, 2015 at 10:03 amLog in to Reply Thanks Dr Mattu. Great case. I invite subscribers to read the interesting M Cadogan`s u wave post in LITFEL http://lifeinthefastlane.com/ecg-library/basics/u-wave/ H Munoz, MD Venezuela Michael K March 30, 2015 at 5:25 pmLog in to Reply Those lateral T wave changes were subtle indeed. But what of the not-so-suble Wellenesquae findings in V2 and V3? Those are what caught my eye. Jesse R March 31, 2015 at 5:08 pmLog in to Reply I only wish there were there were 10/week!! Obviously, that would be unrealistic. Thank you for keeping us on our toes with this one! david k April 1, 2015 at 7:02 amLog in to Reply Hi Dr. Mattu, Great case!!! After I hit the pause button to review the ECG, I was immediately drawn to the ST Depression as well as T Wave inversion noted in Lead AVL. I also, felt that there may be some subtle ST Elevation in the inferior leads with bi-phasic T Wave changes noted in leads V1,V2, & V3. Could you comment on these findings please. Thanks, Dave Lorenzo A April 2, 2015 at 8:39 amLog in to Reply Dear Dr Mattu, just to stay on the topic of subtle changes associated to ACS… In the past you cited a possible sign of impending ischemia suggested by straight or convex non elevated ST segment, as a kind of hyper-acute T wave equivalent. In my short experience this hint have been useful more than ones. I would like to know if there is some literature on this specific topic? Regards, Lorenzo Andreana Alan April 2, 2015 at 3:45 pmLog in to Reply Great case!. I was only focusing on the inverted T AVL and slight inferior st elevations. Any chance you can add a speed control to the videos? With so much great content speeding them up a bit helps me to see more of them. Alexander K April 4, 2015 at 12:29 pmLog in to Reply What is the physiology behind these findings appearing laterally if the lesion is located in the LAD? Is it an anatomical variant? Alex Amal M April 6, 2015 at 8:35 amLog in to Reply Thanks for the comments. Sorry for delayed response: 1. LVH and high voltage can cause a lot of T wave changes, so many of the T-wave abnormalities are non-specific. For example, if you see biphasic Ts if may simply be due to the abnormal repolarization, so I always avoid diagnosing Wellens in the presence of high voltage/LVH. 2. Same point for the TWI in aVL. 3. Lorenzo, you are referring to deWinter T waves. We’ll discuss this in the near future if not already. 4. Jesse, I wish I had time to do this! But I still work 8-9 shifts per month in addn to admin for our dept/residency and teaching….and family…not enough time to do everything I’d like! 5. Alexander, not sure about the physiology for why the changes are lateral and yet the lesion is usually LAD. Leave A Comment Cancel replyYou must be logged in to post a comment.