T Wave

The T wave occurs after the QRS complex and is a result of ventricular depolarization.

T waves should be upright in most leads (except aVR and V1). T waves should be asymmetric in nature. The second portion of the T wave should have a steeper decline when compared to the incline of the first part of the T wave. If the T wave appears symmetric, cardiac pathology may be present such as ischemia.

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Normal ECG

Many abnormal T wave patterns exist which are listed below with examples when available:

• Hyperkalemia
• Wellens syndrome
• Left ventricular hypertrophy with repolarization abnormalities
• Pericarditis (Stage III)
• ARVD
• Hyperacute T waves
• Neurologic injury
• Juvenile T wave
• QT interval prolongation
• Hypertrophic obstructive cardiomyopathy