ECG Basics and Fundamentals: T wave inversions and the importance of precordial lead placement

ECG Weekly Workout with Dr. Amal Mattu


A 32-year-old female with a PMHx of obesity and tobacco use presents to the emergency department with 1 day of sharp midsternal chest pain. Pain is intermittent, non-radiating, and associated with occasion shortness of breath. She appears anxious and her chest pain is found to be partially reproducible on exam. The following ECG is obtained:

Before watching the video, look closely at this ECG and ask yourself:

  1. What is your full ECG interpretation?
  2. What is your differential for the T wave inversions seen in leads V1 & V2?
  3. How would you work up this patient in the emergency department?