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EKGDX Profile picture
@ekgdx
Dec 7, 2022 • 9 tweets • 5 min read • Read on X
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1/ Let’s talk about T waves #CardioTwitter

The T wave represents typically ventricular repolarization. It is the most labile wave on the EKG surface. 

Normal T wave

✅ Morphology: Asymmetric.
✅ Amplitude: ≤6 mm in limb leads and ≤10 mm in precordial leads.

#MedTwitter
2/ Tall upright T wave

Tall upright T waves are usually characterized by tall and peaked shape. 

✅ Amplitude: >6 mm in limb leads and >10 mm in precordial leads.

Causes: Hyperkalemia, hyperacute MI, normal variant, prinzmetal angina, aortic stenosis, LVH, RVH, others. 

#ecg
3/ Notched T wave

Possible causes: May be caused by morphological changes in the cardiomyocytes' action potential waveforms. Another causes include: Drugs (such as Dofetilide, Quinidine, Ranolazine, Verapamil), long QT syndrome, athletes, others.

#MedTwitter #MedStudentTwitter
4/ Inverted T wave

Causes: Myocardial ischemia (acute or chronic), MI, BBB, hypertrophic cardiomyopathy, PE, raised intracranial pressure, persistent juvenile T wave, normal finding in children, LVH, RVH, others. 

Isolated T wave inversion in lead III can be a normal variant.
5/ Biphasic T wave

Biphasic T wave can be with "terminal positivity (down-up)" or "terminal negativity (up-down)".

Causes: Myocardial ischemia, hypokalemia, reperfusion phase, others.

If biphasic T wave with terminal negativity is present in V2-V3, consider Wellens type I.
6/ Giant Inverted T wave

✅ Morphology: Giant and symmetrical.
✅ Amplitude: ≥10 mm. 

Causes: Severe ischemia, pheochromocytoma, electroconvulsive therapy, brain bleed, cocaine abuse, post-pacemaker syndrome, apical hypertrophic cardiomyopathy, others. 

#MedTwitter #ecg
7/ Hyperacute T wave

Hyperacute T wave have been reported in association with acute myocardial ischemia due to critical stenosis or occlusion of a coronary artery that may occur in the very early phases of myocardial infarction within the 30 minutes of onset of symptoms.

#ecg
8/ The EKGs are courtesy of EKGDX App.

You can download the App here: onelink.to/7bp23c

If you want to know more about it, read the following 🧵👇
9/ If you get here, you should know about our threads (check the following🧵👇)

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More from @ekgdx

EKGDX Profile picture
Feb 11, 2023
1/ Let’s talk about focal atrial tachycardia #CardioTwitter.

🧵👇 by @ekgdx

#ekgdx #ecg #ekg #MedTwitter #medicine #medstudents #basic #education #graphic Image
2/ Focal atrial tachycardia is characterized by at least three or more consecutive ectopic P waves with similar morphology, usually arising from a single ectopic focus.

#ekgdx
3/ Criteria

✅ ≥3 consecutive similar ectopic P waves (usually inverted in inferior leads).
✅ Atrial rate >100 bpm.
✅ QRS usually narrow unless pre-existing BBB or aberrant conduction.

#ekgdx
Read 7 tweets
EKGDX Profile picture
Nov 30, 2022
1/ Let’s talk about the ST segment #CardioTwitter.

ST segment normally represents the interval between ventricular depolarization and repolarization.

Normal ST

✅ Usually isolectric or may vary from 0.5 mm below to 1 mm above isolectric line in L leads.

#ekgdx #Medicine Image
2/ ST elevation (STE)

ST changes suggesting myocardial injury:

✅ New STE ≥1 mm in all leads other than V2 or V3.
✅ New STE in V2-V3 ≥2 mm in men older than 40 years old and ≥2.5 mm in men younger than 40 years old or ≥1.5 mm in women.

#ekgdx #Medstudent #MedTwitter Image
3/ Types of ST segment elevation include:

✅ Convex Upward (previous pic)
✅ Horizontal (this one)
✅ Concave Upward (see next)
✅ Obliquely Straight (see next)

#ekgdx #st #MedTwitter #ecg #ekg #CardioTwitter #Medstudent Image
Read 9 tweets
EKGDX Profile picture
Nov 15, 2022
1/ Let’s talk about PR Interval - Segment #CardioTwitter.

The PR interval represents the time between the onset of atrial depolarization and the onset of ventricular depolarization and reflects conduction through the AV node.

🧵by @ekgdx
2/ PR Interval

Criteria

✅ Normal PR interval: 0.12 - 0.20 sec.
✅ Prolonged PR interval: >0.20 sec.
✅ Short PR interval: <0.12 sec.

The term “PQ interval” is preferred by some EKG lover because it is the period actually measured unless the Q wave is absent.

#PR #interval
3/ The PR segment is the segment between the end of the P wave and the start of the QRS complex.

Criteria

✅ Normal PR segment: Usually isolectric.
✅ PR segment elevation: ≥0.5 mm.

PR segment elevation causes: Atrial ischaemia/infarction, myopericarditis, PE, others.

#ekgdx
Read 6 tweets
EKGDX Profile picture
Nov 13, 2022
1/ Let’s talk about P waves #CardioTwitter.

The P wave is the first positive deflection on the EKG and represents atrial depolarization. The first half represents right atrial depolarization and the second half represents left atrial depolarization.

By @ekgdx Image
2/ Normal P wave

Criteria

✅ Axis: 0° to +75°.
✅ Amplitude (L leads): <2.5 mm.
✅ Amplitude (P leads): <1.5 mm.
✅ Duration: 0.08 - 0.11 sec. 
✅ Morphology: Upright in I, II, aVF and inverted in aVR.

#Pwaves #ecg #ekg #ekgdx #medicine #MedTwitter #MedStudentTwitter #basic
3/ Peaked P wave

The morphology is peaked with amplitude ≥2.5 mm, usually in II, III and aVF.

The peaked P wave is a typical characteristic of right atrial abnormality/enlargement. 

Causes: PE, COPD, congenital heart disease, pulmonary hypertension, normal variant, others. Image
Read 12 tweets
EKGDX Profile picture
Nov 12, 2022
Acute pulmonary embolism (PE) is one of the most serious form of venous thromboembolism. The clinical presentation of PE is variable and often nonspecific making the diagnosis challenging.

1/

#CardioTwitter Image
Criteria

✅ Sinus tachycardia (most common).
✅ S1Q3T3 pattern (may be present up to 30% of cases). 
✅ Simultaneous T wave inversions in the inferior leads and right precordial leads can be seen.
✅ Right axis deviation.
✅ RBBB (complete or incomplete).

2/

#MedTwitter #ecg
CT form a real case with PE.

3/

#medicine #MedTwitter #MedStudentTwitter #ct #pe #ekgdx #ekg #ecg Image
Read 4 tweets

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