Inverted t waves

[amy201]

Last week I felt upper chest (inch below my adams apple) pressure. It wasn't debilitating, but it's something I hadn't felt before and wanted it make sure it was "nothing". I went to urgent care and after EKG (blood pressure was fine), the Doc sent me to ER. The EKG he had preformed showed an inverted t wave. Could you please tell me more about inverted t waves?

At the ER, many tests were done: CAT scan, chest XRay, blood work, etc. All came up normal. Another EKG was done and again showed an inverted T wave. I was released and sent home. Of course, I was a wreck and have been having anxiety since then.

I went to a Cardiologist who did another EKG and yes, again the T wave were flipped. My eco that he gave was as he put it "fine". And said don't worry too much about the chest pressure (which comes and goes - and is mild), unless it become debilitating or I get short of breath, etc. I am scheduled for a Stress test this week.

My questions are: Why would the Urgent Care doc send me to the ER with and inverted t wave and the Card didn't seem to think too much of it? That worries me. Also, what causes inverted t waves? I had an EKG done at my physical last year and it wasn't flipped. I do have heart palpatations every now and then. Esp. now, b/c of stress I'm hoping!

Please shed some light on this issue - I would be indebted. Thank you.
Amy

[amy201]

Thank you for your speedy response.

I am a 39 yr old woman, with no family history of heart disease. I don't smoke and am not overweight. Now I'm kicking myself for not asking what leads the inverted t-waves were on! I would imagine (and hope) the Cardiologist would have told me if they were on the "bad" leads. Yikes. I'll have to call tomorrow and find out.

Can I be confident if the stress test this week shows nothing (coupled with the good eco from last week and all the good outcomes of the ER tests) . Meaning would it be fair to say that a heart problem could be ruled out, even though I have the inverted t-waves. Or is that still a warning sign?

thank you,
amy

[Douglas Bogart, MD]

Inverted T-waves can be normal depending on the leads where they are inverted.  Lead 3 for example it can be perfectly normal to have inverted Twaves.  In young women inverted T-waves in V1 and V2 can be normal.  The T-waves are part of the ECG that reflect repolarization and while inversion can be abnormal it can as stated above be anormal finding.