tag:blogger.com,1999:blog-549949223388475481.post4397582128461084324..comments2024-03-28T14:02:08.119-05:00Comments on Dr. Smith's ECG Blog: Hyperacute T-waves that one might attribute to hyperkalemia and acidosisUnknownnoreply@blogger.comBlogger6125tag:blogger.com,1999:blog-549949223388475481.post-56221582848847377492015-11-10T06:58:08.659-06:002015-11-10T06:58:08.659-06:00I have seen this many times: hyperacute T-waves be...I have seen this many times: hyperacute T-waves become less hyperacute, then evolve over time to inverted T-waves.<br />This one shows what happens after the T-wave normalizes: http://hqmeded-ecg.blogspot.com/2011/03/classic-evolution-of-wellens-t-waves.html<br />SteveSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-42066717368529795222015-11-09T18:41:01.750-06:002015-11-09T18:41:01.750-06:00Yes! I suspect the progression from Hyperacute T-w...Yes! I suspect the progression from Hyperacute T-waves (vessel closed), to "Reperfusion/Wellen's" Waves must sometimes involve an "intermediate phase" where the Hyperacute T's lessen in magnitude. How often? How transient? I have no idea! Super interesting. Anonymoushttps://www.blogger.com/profile/09692498213534558770noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-11199192922330626072015-11-09T17:05:29.395-06:002015-11-09T17:05:29.395-06:00Sam,
Reperfusion T-waves are not universal. Gener...Sam,<br />Reperfusion T-waves are not universal. Generally, it depends on the level of troponin, although in this case there was plenty of infarction (peak trop I = 12). Also, it sometimes take more time for the T-wave inversion to develop. I'm not sure if it did so on subsequent ECGs.<br />I haven't looked at this case for a long time. It is pretty cool!<br />Steve Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-8336008840584219132015-11-09T15:29:49.626-06:002015-11-09T15:29:49.626-06:00Steve,
If the artery spontaneously opened and ther...Steve,<br />If the artery spontaneously opened and there was re-perfusion, how do you explain the still uniformly upright T's on the 2nd ECG, as opposed to reperfusion T's or "Wellen's" waves?<br /><br />SamAnonymoushttps://www.blogger.com/profile/09692498213534558770noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-42412165143501927912012-08-18T06:41:56.578-05:002012-08-18T06:41:56.578-05:00Yes, t-waves of hyperK are usually preceded by a h...Yes, t-waves of hyperK are usually preceded by a horizontal ST segment, such that there is an exaggeration of the upward concavity.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-2109972563341191932012-08-18T01:47:44.066-05:002012-08-18T01:47:44.066-05:00Dr. Smith,
This observation may seem retrospectiv...Dr. Smith,<br /><br />This observation may seem retrospective, but at first glance of the ECG, the bases of the T waves seemed wider than I've seen for hyper-k T waves..<br /><br />Do you agree with that observation?<br /><br />Dave BDave Bhttps://www.blogger.com/profile/04348546121665459931noreply@blogger.com