{"id":21322,"date":"2016-05-10T13:06:01","date_gmt":"2016-05-10T07:36:01","guid":{"rendered":"https:\/\/cardiophile.org\/?p=21322"},"modified":"2023-01-09T07:51:21","modified_gmt":"2023-01-09T02:21:21","slug":"giant-wide-t-inversion-cardiology-mcq","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/giant-wide-t-inversion-cardiology-mcq\/","title":{"rendered":"Giant wide T inversion – Cardiology MCQ"},"content":{"rendered":"

Giant wide T inversion may be seen in all except:<\/strong>
\na) After a cardiac arrest
\nb) Subarachnoid hemorrhage
\nc) Hyperkalemia
\nd) Takotsubo cardiomyopathy
\nCorrect answer: c) Hyperkalemia<\/strong>
\nGiant T wave inversion can be broad and deep or just deep T inversions. A depth of T wave of 10 mm or above is generally considered as deep T inversion [1]. Giant T wave inversions with depth of 35 mm have also been described in literature [2]. Deep T inversions without gross increase in width can occur in ischemia and hypertrophic cardiomyopathy. In a study involving 864 patients with hypertrophic cardiomyopathy, 15% had giant T wave inversion [3]. While giant T inversions occurred in about one third of patients with apical hypertrophic cardiomyopathy, it was seen in only 6.2% of those with asymmetric septal hypertrophy and one fourth of those with mixed pattern of hypertrophy. But there was no significant correlation between the apical myocardial thickness and the amplitude of T wave inversion.
\nIn ischemia the width may sometimes be increased. Absence of left ventricular hypertrophy and symmetric nature of the T inversion (as in the ECG illustrated) has been suggested as indicators of myocardial ischemia in giant T wave inversion [4]. Deep and wide negative T waves are an important feature of post anoxic state and occurs typically after a Stokes-Adam attack. Presence of such broad and negative T waves in a case of complete heart block would indicate that the person had a recent episode of asystole. Since the QT interval is grossly prolonged in that situation, there is a high chance of polymorphic ventricular tachycardia (torsades des pointes). Giant wide T inversion can occur in intracranial bleeds like subarachnoid hemorrhage. Giant T wave inversion has been reported in pheochromocytoma, after electroconvulsive therapy [1] and Takotsubo cardiomyopathy [5]. Giant T wave inversion can also occur with cardiogenic, but non ischemic pulmonary edema, associated with prolongation of QT interval and resolving after resolution of symptoms [6].
\nReferences<\/strong><\/p>\n

    \n
  1. Said SA, Bloo R, de Nooijer R, Slootweg A. Cardiac and non-cardiac causes of T-wave inversion in the precordial leads in adult subjects: A Dutch case series and review of the literature. World J Cardiol. 2015 Feb 26;7(2):86-100.<\/li>\n
  2. Yue-Chun L, Lin JF. Rare giant T-wave inversions associated with myocardial stunning: report of 2 cases. Medicine (Baltimore). 2014 Jun;93(4):e39.<\/li>\n
  3. Kim SH, Oh YS, Nam GB, Choi KJ, Kim DH, Song JM, Kang DH, Song JK, Kim YH. Morphological and Electrical Characteristics in Patient with Hypertrophic Cardiomyopathy: Quantitative Analysis of 864 Korean Cohort. Yonsei Med J. 2015 Nov;56(6):1515-21.<\/li>\n
  4. Otrusinik R, Alpert MA, Hamm CR, Bikkina M, Porubicin M, Panayiotou H. Factors predicting coronary artery disease in patients with giant negative T waves. Am J Cardiol. 2000 Apr 1;85(7):873-5, A9.<\/li>\n
  5. Yaguchi M, Yaguchi H, Takahashi N. A case of asymptomatic takotsubo cardiomyopathy with intraventricular thrombus associated with epileptic seizure. Brain Nerve. 2011 Aug;63(8):897-900.<\/li>\n
  6. Littmann L. Large T wave inversion and QT prolongation associated with pulmonary edema: a report of nine cases. J Am Coll Cardiol. 1999 Oct;34(4):1106-10.<\/li>\n<\/ol>\n
    <\/div>\n","protected":false},"excerpt":{"rendered":"

    Giant wide T inversion may be seen in all except: a) After a cardiac arrest b) Subarachnoid hemorrhage c) Hyperkalemia d) Takotsubo cardiomyopathy Correct answer: c) Hyperkalemia Giant T wave inversion can be broad and deep or just deep T inversions. A depth of T wave of 10 mm or above is generally considered as deep T […]<\/p>\n","protected":false},"author":1,"featured_media":17497,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[3,5,6],"tags":[],"class_list":["post-21322","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cardiology-mcq","category-dm-dnb-cardiology-entrance","category-ecg-electrophysiology"],"yoast_head":"\nGiant wide T inversion - Cardiology MCQ - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/giant-wide-t-inversion-cardiology-mcq\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Giant wide T inversion - Cardiology MCQ - All About Cardiovascular System and Disorders\" \/>\n<meta property=\"og:description\" content=\"Giant wide T inversion may be seen in all except: a) After a cardiac arrest b) Subarachnoid hemorrhage c) Hyperkalemia d) Takotsubo cardiomyopathy Correct answer: c) Hyperkalemia Giant T wave inversion can be broad and deep or just deep T inversions. 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