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In pulmonary embolism, T wave can be symmetrically inverted at V2 to V4 leads but sinus tachycardia is usually the more common finding. T wave inversion is only present in 19% of mild pulmonary embolism, but the T inversion can be present in 85% of the cases in severe pulmonary embolism. Besides, T inversion can also exists in leads III and aVF ...
Takotsubo syndrome represents about 2% of all patients (and 5–6% of all female patients) who are initially diagnosed with acute coronary syndrome (ACS). [6] [69] It accounts for 0.02% of all hospitalizations in the US. [6] About 90% of TTS patients are women, [6] [69] whose mean age is about 68 years, and 80% of whom are older than 50 years. [6]
Originally thought of as two separate types, A and B, it is now considered an evolving wave form, initially of biphasic T wave inversions and later becoming symmetrical, often deep (>2 mm), T wave inversions in the anterior precordial leads. [1]
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In electrocardiography, a strain pattern is a well-recognized marker for the presence of anatomic left ventricular hypertrophy (LVH) in the form of ST depression and T wave inversion on a resting ECG. [1] It is an abnormality of repolarization and it has been associated with an adverse prognosis in a variety heart disease patients.
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Other EKG signs include a right bundle branch block [13] as well as T wave inversions in the anterior leads, which are "thought to be the consequence of an ischemic phenomenon due to low cardiac output in the context of RV dilation and strain."
At this point there may be signs of ventricular strain pattern (ST segment depression and T wave inversion) on the EKG, suggesting subendocardial ischemia. The subendocardium is the region that is most susceptible to ischemia because it is the most distant from the epicardial coronary arteries.