![]() ![]() A normal T-wave usually has amplitude of less than 5mm in the precordial leads and less than 10mm in the limb leads. In general, T-waves are tallest in leads II and V4 and will decrease in size with age. The normal T-wave appearance varies based on lead placement, age, and sex. The T-wave represents the period of ventricular repolarization on the ECG. Now we are going to turn our attention to the T-waves. ![]() Last time we reviewed the ECG findings associated with left main coronary artery disease, where we discussed the meaning of ST elevation in lead aVR. ![]() Welcome to Part II of a three-part series on subtle ECG findings in ACS. That is why we are concerning ourselves with subtlety. However, more often than not, patients are not obvious, especially in the early stages of ACS. Sometimes it seems that the patient has read the textbook. Sometimes patients presenting with ACS are obvious. Author: Jamie Santistevan MD EM Resident Physician, University of Wisconsin) // Edited by: Alex Koyfman, MD EM Attending Physician, UT Southwestern Medical Center / Parkland Memorial Hospital) & Justin Bright, MD (EM Attending Physician, Henry Ford Hospital, if you could identify a patient with complete coronary vessel occlusion almost immediately after it occurs, before the ST segments begin to elevate? What if you could pick up the very subtle, early MI? We know that early recognition and intervention improves outcomes in patients with coronary artery occlusion. ![]()
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