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T-wave inversion in the right precordial leads

MedGen UID:
871172
•Concept ID:
C4025646
•
Finding
HPO: HP:0003140

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVT-wave inversion in the right precordial leads

Conditions with this feature

Arrhythmogenic right ventricular dysplasia 4
MedGen UID:
356107
•Concept ID:
C1865881
•
Disease or Syndrome
Arrhythmogenic right ventricular cardiomyopathy (ARVC) – previously referred to as arrhythmogenic right ventricular dysplasia (ARVD) – is characterized by progressive fibrofatty replacement of the myocardium that predisposes to ventricular tachycardia and sudden death in young individuals and athletes. It primarily affects the right ventricle, and it may also involve the left ventricle. The presentation of disease is highly variable even within families, and some affected individuals may not meet established clinical criteria. The mean age at diagnosis is 31 years (±13; range: 4-64 years).
See: Condition Record
Arrhythmogenic right ventricular dysplasia 3
MedGen UID:
356108
•Concept ID:
C1865882
•
Disease or Syndrome
Arrhythmogenic right ventricular cardiomyopathy (ARVC) – previously referred to as arrhythmogenic right ventricular dysplasia (ARVD) – is characterized by progressive fibrofatty replacement of the myocardium that predisposes to ventricular tachycardia and sudden death in young individuals and athletes. It primarily affects the right ventricle, and it may also involve the left ventricle. The presentation of disease is highly variable even within families, and some affected individuals may not meet established clinical criteria. The mean age at diagnosis is 31 years (±13; range: 4-64 years).
See: Condition Record
Arrhythmogenic right ventricular dysplasia 3
Arrhythmogenic right ventricular dysplasia 4

Professional guidelines

PubMed

The value of different electrocardiographic depolarization criteria in the diagnosis of arrhythmogenic right ventricular dysplasia/cardiomyopathy.
Peters S, Trümmel M, Koehler B, Westermann KU
J Electrocardiol 2007 Jan;40(1):34-7. Epub 2006 Nov 22 doi: 10.1016/j.jelectrocard.2006.10.002. PMID: 17118392

Recent clinical studies

Etiology

Right-sided Electrocardiogram in Patients With Acute Pulmonary Embolism.
Jahanian S, Ayati A, Hosseini K, Heidari F, Yadangi S, Ahmadian T, Hosseinsabet A, Jenab Y
Crit Pathw Cardiol 2022 Mar 1;21(1):24-29. doi: 10.1097/HPC.0000000000000273. PMID: 35191863
Distinctive ECG patterns in healthy black adults.
Walsh B, Macfarlane PW, Prutkin JM, Smith SW
J Electrocardiol 2019 Sep-Oct;56:15-23. Epub 2019 Jun 13 doi: 10.1016/j.jelectrocard.2019.06.007. PMID: 31229678
Pseudo-Wellens' syndrome in pulmonary embolism.
Sedhai YR, Basnyat S, Bhattacharya PT
BMJ Case Rep 2018 Dec 19;11(1) doi: 10.1136/bcr-2018-227464. PMID: 30573540Free PMC Article
Isolated T-wave inversion in the right precordial leads.
MacKenzie R
J Insur Med 2014;44(2):122-6. PMID: 25816472
The role of the initial 12-lead ECG in risk stratification of patients with acute coronary syndrome.
Schweitzer P, Keller S
Bratisl Lek Listy 2001;102(9):406-11. PMID: 11763676

Diagnosis

Right-sided Electrocardiogram in Patients With Acute Pulmonary Embolism.
Jahanian S, Ayati A, Hosseini K, Heidari F, Yadangi S, Ahmadian T, Hosseinsabet A, Jenab Y
Crit Pathw Cardiol 2022 Mar 1;21(1):24-29. doi: 10.1097/HPC.0000000000000273. PMID: 35191863
Distinctive ECG patterns in healthy black adults.
Walsh B, Macfarlane PW, Prutkin JM, Smith SW
J Electrocardiol 2019 Sep-Oct;56:15-23. Epub 2019 Jun 13 doi: 10.1016/j.jelectrocard.2019.06.007. PMID: 31229678
Pseudo-Wellens' syndrome in pulmonary embolism.
Sedhai YR, Basnyat S, Bhattacharya PT
BMJ Case Rep 2018 Dec 19;11(1) doi: 10.1136/bcr-2018-227464. PMID: 30573540Free PMC Article
The role of the initial 12-lead ECG in risk stratification of patients with acute coronary syndrome.
Schweitzer P, Keller S
Bratisl Lek Listy 2001;102(9):406-11. PMID: 11763676
Arrhythmogenic right ventricular dysplasia/cardiomyopathy: a review.
Marcus FI, Fontaine G
Pacing Clin Electrophysiol 1995 Jun;18(6):1298-314. doi: 10.1111/j.1540-8159.1995.tb06971.x. PMID: 7659585

Therapy

Pseudo-Wellens' syndrome in pulmonary embolism.
Sedhai YR, Basnyat S, Bhattacharya PT
BMJ Case Rep 2018 Dec 19;11(1) doi: 10.1136/bcr-2018-227464. PMID: 30573540Free PMC Article
Syncope with QT interval prolongation and T-wave inversion: pulmonary embolism.
Zhao YT, Wang L, Wang B
Am J Emerg Med 2015 Oct;33(10):1546.e5-6. Epub 2015 Jul 21 doi: 10.1016/j.ajem.2015.07.023. PMID: 26286817
What is the significance of T-wave inversion in the precordial leads?
Tsiperfal A, Scheibly K
Prog Cardiovasc Nurs 2009 Dec;24(4):202-3. doi: 10.1111/j.1751-7117.2009.00061.x. PMID: 20002347
Clinical implication of left precordial T wave inversions in the presence of complete right bundle branch block.
Suzuki J, Shin WS, Shimamoto R, Yamazaki T, Tsuji T, Murakawa Y, Nakajima T, Toyo-oka T, Nishikawa J, Ohotomo K, Nagai R, Omata M
Jpn Heart J 1999 Nov;40(6):745-53. doi: 10.1536/jhj.40.745. PMID: 10737558
Repolarization abnormalities after catheter ablation of accessory atrioventricular connections with radiofrequency current.
Kalbfleisch SJ, Sousa J, el-Atassi R, Calkins H, Langberg J, Morady F
J Am Coll Cardiol 1991 Dec;18(7):1761-6. doi: 10.1016/0735-1097(91)90518-e. PMID: 1960327

Prognosis

Right-sided Electrocardiogram in Patients With Acute Pulmonary Embolism.
Jahanian S, Ayati A, Hosseini K, Heidari F, Yadangi S, Ahmadian T, Hosseinsabet A, Jenab Y
Crit Pathw Cardiol 2022 Mar 1;21(1):24-29. doi: 10.1097/HPC.0000000000000273. PMID: 35191863
Predictors of Adverse Outcomes in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy: A Meta-Analysis of Observational Studies.
Bazoukis G, Letsas KP, Thomopoulos C, Tse G, Korantzopoulos P, Naka KK, Kalfakakou V, Vlachos K, Bazoukis X, Papadatos SS, Michelongona P, Saplaouras A, Georgopoulos S, Karamichalakis N, Asvestas D, Liu T, Efremidis M, Sideris A, Tsioufis C, Baranchuk A, Stavrakis S
Cardiol Rev 2019 Jul/Aug;27(4):189-197. doi: 10.1097/CRD.0000000000000220. PMID: 31180938
Changes in follow-up ECG and signal-averaged ECG in patients with arrhythmogenic right ventricular cardiomyopathy.
Bae MH, Kim JH, Jang SY, Park SH, Lee JH, Yang DH, Park HS, Cho Y, Chae SC
Pacing Clin Electrophysiol 2014 Apr;37(4):430-8. Epub 2013 Oct 25 doi: 10.1111/pace.12285. PMID: 24164254
Prevalence and prognostic significance of T-wave inversions in right precordial leads of a 12-lead electrocardiogram in the middle-aged subjects.
Aro AL, Anttonen O, Tikkanen JT, Junttila MJ, Kerola T, Rissanen HA, Reunanen A, Huikuri HV
Circulation 2012 May 29;125(21):2572-7. Epub 2012 May 10 doi: 10.1161/CIRCULATIONAHA.112.098681. PMID: 22576982
The role of the initial 12-lead ECG in risk stratification of patients with acute coronary syndrome.
Schweitzer P, Keller S
Bratisl Lek Listy 2001;102(9):406-11. PMID: 11763676

Clinical prediction guides

Validation of an electrocardiographic marker of low voltage areas in the right ventricular outflow tract in patients with idiopathic ventricular arrhythmias.
Parreira L, Marinheiro R, Carmo P, Chambel D, Mesquita D, Amador P, Marques L, Mancelos S, Reis RP, Adragao P
J Cardiovasc Electrophysiol 2022 Nov;33(11):2322-2334. Epub 2022 Aug 21 doi: 10.1111/jce.15654. PMID: 35971685
Right-sided Electrocardiogram in Patients With Acute Pulmonary Embolism.
Jahanian S, Ayati A, Hosseini K, Heidari F, Yadangi S, Ahmadian T, Hosseinsabet A, Jenab Y
Crit Pathw Cardiol 2022 Mar 1;21(1):24-29. doi: 10.1097/HPC.0000000000000273. PMID: 35191863
Predictors of Adverse Outcomes in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy: A Meta-Analysis of Observational Studies.
Bazoukis G, Letsas KP, Thomopoulos C, Tse G, Korantzopoulos P, Naka KK, Kalfakakou V, Vlachos K, Bazoukis X, Papadatos SS, Michelongona P, Saplaouras A, Georgopoulos S, Karamichalakis N, Asvestas D, Liu T, Efremidis M, Sideris A, Tsioufis C, Baranchuk A, Stavrakis S
Cardiol Rev 2019 Jul/Aug;27(4):189-197. doi: 10.1097/CRD.0000000000000220. PMID: 31180938
Changes in follow-up ECG and signal-averaged ECG in patients with arrhythmogenic right ventricular cardiomyopathy.
Bae MH, Kim JH, Jang SY, Park SH, Lee JH, Yang DH, Park HS, Cho Y, Chae SC
Pacing Clin Electrophysiol 2014 Apr;37(4):430-8. Epub 2013 Oct 25 doi: 10.1111/pace.12285. PMID: 24164254
Angiocardiographic findings in patients with biphasic T-wave inversion in precordial leads.
Akhtar P, Rizvi SN, Tahir F, Saleem D, Mulla J, Saghir T
J Pak Med Assoc 2012 Jun;62(6):548-51. PMID: 22755337

Recent systematic reviews

A systematic review of electrocardiographic changes in healthy high-altitude populations.
Parodi JB, Ramchandani R, Zhou Z, Chango DX, Acunzo R, Liblik K, Farina JM, Zaidel EJ, Ruiz-Mori E, Carreón JMA, Liprandi AS, Baranchuk A; ANDES (Altitude Non-specific Distributed ECG Screening) Project Investigators
Trends Cardiovasc Med 2023 Jul;33(5):309-315. Epub 2022 Feb 2 doi: 10.1016/j.tcm.2022.01.013. PMID: 35121084

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