What is an inverted T wave?

An inverted T wave is a specific pattern seen on an electrocardiogram (ECG or EKG), where the T wave, which typically represents the repolarization phase of the heart's electrical cycle, appears as a downward deflection instead of the usual upward one. This abnormality can be indicative of various cardiac conditions or, in some cases, may be a normal variant in certain leads or age groups. In adults, an inverted T wave is often associated with conditions such as coronary ischemia, where there is a lack of oxygenated blood supply to the heart muscle. It can also be a sign of Wellens' syndrome, which is a specific pattern of T wave inversion in the anterior leads of the ECG that is associated with critical narrowing of the coronary arteries. Additionally, inverted T waves can be seen in left ventricular hypertrophy, where the heart muscle has thickened, and in certain central nervous system (CNS) disorders that affect the heart's electrical activity. However, it's important to note that in pediatric patients, inverted T waves in the right precordial leads (V1 to V3) can be a normal finding and not necessarily indicative of a pathological condition. In summary, while inverted T waves can be a sign of serious cardiac conditions, they must be interpreted within the context of the patient's clinical presentation, medical history, and the specific ECG lead in which they are observed.

The T wave is therefore reported as negative instead of positive in EKG. ... T-wave inversion (negative T waves) can be a sign of coronary ischemia, Wellens' syndrome, left ventricular hypertrophy, or CNS disorder. Pediatric inverted T waves: normally found in the right precordial leads.