I am a 57 year old male in good health. I exercise (run or swim) 5 days per week. No history of heart problems, although both parents had late onset cardiovascular desease. My Cholesterol is slightly elevated (209) but the HDL/LDL ratio is fine. I've been under a great deal of stress lately and just had an EKG that showed a flipped (depressed) T wave. My last EKG (three years ago) showed no such abnormality. My blood pressure is good: 106/64 and heart rate is 60 beats/min. The only medications that I take on a regular basis are 25 mg Zoloft daily and allergy meds in allergy season. My doctor does not seem too concerned but I have scheduled an echocardigram and stress EKG.
What are the likely causes and consequences of the depressed T wave/
there are many causes of an inverted T wave: One of which is myocardial ischemia, but this is unusual in your case given the fact that it happens in a single-lead. Myocardial ischemia usually follows the territories of a coronary artery, and hence the EKG changes are seen in the entire distribution. apart for myocardial ischemia there are many many other causes of a flipped T wave including electrolyte abnormalities, temperature abnormalities, heart rate, blood pressure, central nervous system problems, kidney problems, syncope which can cause it. The important thing to note is that the prognosis of this flipped T waves are dependent on the cause.
You did not mention any symptoms of chest pain or shortness of breath with exertion so I am assuming that these are not present. a flipped T wave in the setting of the symptoms may indicate myocardial ischemia, but without it it most likely represents one of the other problems. I think it is appropriate that you have a stress EKG, and that she notes specifically if he developed any symptoms of chest pain or shortness of breath. If you develop any these symptoms, or more T waves invert then you may need a left heart catheterization.
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