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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES & RELATED

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Wednesday, May 5, 2021

Hyperacute T-waves

Emergency Medicine Cases - B Jesse McLaren - May 2021
“Take home points on hyperacute T-aves and occlusion MI
  1. Tall T-waves can be a normal variants (including early repolarization), secondary to abnormal depolarization (LBBB, LVH), or a primary repolarization abnormality (hyperkalemia, occlusion MI)
  2. “Peaked T-waves” from hyperkalemia are diffuse, look pinched (narrow base, sharp peak), and are associated with other signs of hyperkalemia (brady, junctional rhythm, long PR, wide QRS)
  3. “Hyperacute T-waves” from OMI are regional, look inflated (wide base, round peak, large relative to the QRS), and are associated with other signs of occlusion like acute Q/loss of R waves, STE or reciprocal STD
  4. Variants of hyperacute T-waves include: upsloping STD + hyperacute T wave (deWinter T wave), and anterior QS waves with hyperacute T-waves (T/QRS>0.36, which differentiates from LV aneurysm)”