Causes of Abnormalities in the T-Wave on an EKG

The heart has its independent electrical system— a network of nerves located throughout all its chambers, which mediate electrical impulses that enable chambers to contract in a synchronized rhythm and sequence. The EKG (Electrocardiogram) — through electrodes attached to body parts such as the arms, legs, and the chest — serves as a tool that records the electrical activity by producing records of tracings or waves based on the magnitude and direction of electrical currents in each heartbeat, or due to the contraction of heart muscles cells found in the two chambers: the atria and ventricles.

Right and left atrial contractions depict the P wave; right and left ventricular contractions depict 3 waves also referred to as the Q-R-S wave; and the last wave or T-wave depicts electrical activity during repolarization, the instance wherein the ventricles charge for the next contraction. Abnormalities found in the recorded frequency may provide insight into dysfunctions and grave conditions of the heart.

Categories: Causes of T-wave Abnormality

Under normal circumstances, the T-wave pattern is both upright and inverted. T-wave abnormalities may be detected in various manifestations — flattening of the t-wave, tall and peaked patterns, and complete inversions.

1. Tall and peaked patterns are often produced by increased blood potassium levels (hyperkalemia).
2. Inverted patterns often result from chronic pericarditis, evolving myocardial infarction, ventricular hypertrophy, conduction block, acute cerebral disease, other cardiac diseases.
3. Flattened T-waves are often associated with nonspecific symptoms or states.

Non-specific symptoms and conditions that cause T-wave abnormality

T –wave abnormalities may not necessarily indicate the presence of a severe heart condition. There are non-specific wave changes that result from common, non-specific causes of T-wave abnormality which includes the following:

1. No obvious causes, which are usually associated with women
2. Fever
3. Metabolic Changes
4. Acidosis or Alkalosis

Furthermore, abnormalities may be detected even in healthy and well-trained people. As such, what needs to be clarified about T-wave abnormalities is that readings are not independently used as sole bases of diagnosing a possible condition. This is because, with the general exception of hyperkalemia, T - wave abnormality does not conclusively and definitively prove the presence of severe conditions.

Often, fluctuations should be interpreted along with other factors, including clinical procedures and further ST waveforms. Doctors may also perceive the abnormality as indicative of an alarming condition only when it is accompanied by chest pains.

Specific states or conditions that cause T-wave abnormality

Complete inversions can signify the presence of cardiovascular diseases and other serious complications, which include the following:

1. Ischemia is a condition in which oxygenated blood becomes constrained in a certain body part. Cardiac ischemia refers to the lack of blood and oxygen supply into the heart muscle; whereas ischemic heart disease refers to heart complications that result from narrowed arteries found in the heart, and this condition can possibly cause heart attacks. Ischemia also causes angina pectoris or chest pains. Isolated T-wave abnormalities usually do not indicate ischemia.
2. Myocardial infarction is usually caused by atherosclerotic heart disease. It refers to the death of myocardial cells, wherein infarction activity usually occurs in the left ventricle.
3. Hyperkalemia, wherein excessive levels of potassium are found in the blood, can be a fatal condition. Severe cases of this condition can suppress the heart’s electrical activity, and render the heart to stop beating.

References

https://www.emedicinehealth.com/electrocardiogram_ecg/article_em.htm

https://www.medicinenet.com/hyperkalemia/article.htm

https://americanheart.org/presenter.jhtml?identifier=251