EKG of the Week

A 54 y/o male with a history of HTN and DM presents c/o chest pain.

Q1. What does the EKG demonstrate?

Q2. Are there any signs of ischemia on this EKG?

A1. T wave inversions in leads III, aVR, and V1

A2. No. This is a normal finding.

T wave inversions can represent ischemia. When T wave inversions are present, patterns should be sought to see if they correspond to any particular wall of the heart. For example, if T wave inversions are identified in lead III, lead II and aVF should be scrutinized looking for T wave inversions as a sign of inferior wall ischemia. However, some leads can have T wave inversions as a normal finding. These leads are leads III, aVR, and V1. If T wave inversions are identified in only these leads, that is not a sign of ischemia. Rather, that is a normal finding.

This EKG demonstrates T wave inversions in leads III, aVR and V1. However, this is an example of a normal EKG.