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T wave inversions on EKG
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An_250506 posted:
Hi there -

I am a 50 year old female (very healty, don't smoke/don't drink) - I workout 3 times a week. My heart was fluttering .Went to primary physician. EKG showed "abnormal". Flipped T wave in 2 leads (I think 2 & 3), no Q waves, no ST changes. It also said "borderline PR interval"... not sure what that last part means. My blood work was great - all normal. I then did a stress test on a treadmill and my stamina was excellent, my blood pressure reaction to the exercise was good. He said after that that "I passed" the stress test just fine. So, he said "no blockages". I've had the holter monitor on all day today - so that will be next - to see what the results of that are. Quite a bit of fluttering in the morning - and hardly any this afternoon/evening.

I've read that T wave inversions in 1 lead can be normal. But, everything I'm reading seems to indicate that if you have it in 2 leads - it can mean a problem. I don't have ANY symptoms other than the fluttering. I can work out HARD - and often attend "boot camp" classes and do them with no problem.

Can anyone tell me how serious this sounds with 2 leads having the inversion?

Thank you so much. J
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cardiostarusa1 responded:
Hi:

"EKG showed "abnormal". Flipped T wave in 2 leads (I think 2 & 3), no Q waves, no ST changes."

"I've read that T wave inversions in 1 lead can be normal. But, everything I'm reading seems to indicate that if you have it in 2 leads - it can mean a problem."

As reported, as applicable, typically, a lone or single (isolated) inverted T wave (occurs in the heart's electrical conduction cycle when the heart is getting ready to pump blood again) is not that concerning.

Though, as applicable, recurring T wave abnormalities can provide added evidence to support clinical diagnosis, except for hyperkalemia (high potassium level), T wave abnormality alone is not diagnostic of any particular condition. The T wave must be considered along with QRS and ST segment abnormalities.

"It also said "borderline PR interval".

The PR interval (the time in seconds from the beginnging of the P wave wave to the beginning of the QRS complex, 0.12 to 0.20) may/can be deemed shortened, prolonged or borderline of either. This has various causes or in some cases may/can be deemed a normal variant.

"Quite a bit of fluttering in the morning."

As applicable to the patient, the most common type of palpitations, premature ventricular contractions (PVCs, occurs even in many heart-healthy individuals), is described that the heart is flip-flopping, fluttering, jumping, pausing or stopping briefly (though it's actually not doing that), pounding, skipping, thumping, or strong, hard, or forceful beats being felt in the chest, neck, throat, and has various causes (cardiac and non-cardiac) or triggers.

PVCs are typically harmless, however, the main problem or concern (even more so, much more emphasized for those with certain major or serious heart conditions) with PVCs is when sustained ventricular tachycardia (runs of PVCs over 30 seconds) occurs.

Symptoms that may/can occur wih PVCs includes none at all or chest pain/discomfort/pressure/tightness, shortness of breath, lightheadedness/dizziness, and in uncommon to rare cases, near-syncope or syncope (temporary loss of consciousness, includes fainting and passing out).

Best of luck down the road of life.

Take care,

CardioStar*

WebMD member (since 8/99)

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James Beckerman, MD, FACC responded:
Your stress test sounds very encouraging!

Without seeing your electrocardiogram it's difficult to comment on two leads in isolation. But in some cases it is possible for T wave inversions to be suggestive of thickening of the heart muscle. But I would not want to raise any concerns of that given that I haven't seen your ECG. I would defer to your physician in terms of evaluating the big picture. It may be helpful to see the results of your monitor as well before drawing any conclusions.
 
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patient19 replied to James Beckerman, MD, FACC's response:
Thank you so much for your feedback. My 24 hour monitor was completed on Tuesday morning and I was told today that I won't have results until Monday. Crazy how long it takes to get the results. I'll report back on e I have that.

Thanks again. J
 
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patient19 replied to cardiostarusa1's response:
Thank you so much for your reply! I will have my holter test results back on Monday. I'll report back. Thanks again, J
 
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cardiostarusa1 replied to patient19's response:
You're welcome.

Take good care,

CardioStar*

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