BMJ Case Reports 2013; doi:10.1136/bcr-2012-008219
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Not all T wave inversions are ischaemic

  1. A C Nagamani1
  1. 1Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India
  2. 2Department of Medicine, Baroda Medical College, Baroda, Gujarat, India
  3. 3Sri Jayadeva Institute of Cardiovascular Sciences, Bangalore, Karnataka, India
  1. Correspondence to Dr Ravindran R, rravi_dr{at}


A 52- year-old man was referred as a case of acute coronary syndrome (ACS) for he had chest pain, vomiting and deep T wave inversions on ECG. Physical examination was normal except for  blood pressure of 190/100 mm Hg. ECG (figure 1) satisfied voltage criteria for left ventricular hypertrophy along with deep asymmetrical T wave inversions, a prominent U wave and a prolonged corrected QT interval (QTc 560 ms). Echocardiogram confirmed concentric left ventricular hypertrophy but …

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