Tuesday, May 26, 2015

New 40 minute lecture on T-wave Inversion



T-wave Inversion

I just found one mistake at minutes 7:00 to 7:30: 

The QRS axis is 90 degrees and the T-wave axis minus 30, for a QRST angle of 120 degrees.


10 comments:

  1. Fantastic lecture. Thank you. Please record more.

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    Replies
    1. Jim,
      Thanks! Please spread the word.
      You can see other lectures posted down the sidebar.
      Steve

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  2. thanks dr Smith, very interesting and practic information

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  3. I think that QRS axis is +60 and T wave axis is -30 so the difference is 90 ( min 7:00 to 7:30) ? But what is normal range for Axis difference between QRS and T wave and its significance ?

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    1. Normal is not easily defined, but as the difference gets larger, the risk gets proportionally larger. > 100 definitely abnormal. My attention is caught if the angle is greater than 60 degrees, but this is not definitely abnormal.

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    2. But i know that If QRS-T angle >100 ,It's suspicious for secondary abnormality rather than primary as LVH ,and There is a big chance it’s not a STEMI ?
      So when to consider QRS/T angle abnormal if more than 100 ?

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  4. No good data. Large QRST angle does not imply STEMI. greater than 100 I would always consider abnormal. What it indicates depends on many factors.

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  5. I was waiting for this kind of lecture since long..THNX U sooo much...My question is in majority of females with or without chest pain we see so many repolarisation abnormalities so calles T wave changes..why so? It unnecessarily ends up investigating further including angio..as they complaints also some kind of non specific chest pain many times...Sir please opine..thanks once again

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  6. Only because the usual teaching is that T-wave inversion is ischemia and dangerous, when in fact most is benign. But it is not simple to tell the difference. Takes lots of study and experience.

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