What causes peaked T waves?

As a medical professional with expertise in cardiology, I can explain that peaked T waves on an electrocardiogram (ECG) can result from a variety of conditions. It's important to note that T wave changes are often non-specific and can be influenced by a range of factors. Here are some common causes: 1. Electrolyte Imbalances: Hyperkalemia, a condition where there is too much potassium in the blood, is a well-known cause of peaked T waves. The excess potassium affects the electrical conduction system of the heart, leading to this distinctive ECG pattern. 2. Ischemia: Reduced blood flow to the heart muscle can cause changes in the T wave, including low amplitude or inverted T waves, although this is not typically associated with peaked T waves. 3. Acute Myocardial Infarction (AMI): In the early stages of a heart attack, T waves can become tall and peaked, particularly in the leads corresponding to the area of the heart affected by the infarction. 4. Drugs and Toxins: Certain medications and toxins can affect the ECG, including tricyclic antidepressants, some antiarrhythmic drugs, and cocaine, which can cause T wave changes. 5. Hypoxia: Insufficient oxygen in the body can lead to peaked T waves due to the effects on heart muscle cells. 6. Central Nervous System (CNS) Lesions: Certain brain conditions can affect the autonomic control of the heart, leading to T wave changes. 7. Early Repolarization Syndrome: This is a benign condition where T waves are abnormally shaped, often appearing tall and symmetrical, particularly in young individuals. 8. Hyperthyroidism: An overactive thyroid can also cause changes in the ECG, including peaked T waves. It's crucial to consider the clinical context and perform a thorough evaluation when interpreting ECG changes. A single peaked T wave finding should not be taken in isolation but should be considered alongside the patient's symptoms, medical history, and other diagnostic information.

In general, T wave changes are very non-specific. They can occur with hyperventilation, anxiety, drinking hot or cold beverages, and positional changes. ... Hyperkalemia (hyperpotassemia) can cause tall, peaked T waves. Hypokalemia and ischemia can cause low amplitude or inverted T waves.