@article {Peckbcr-2018-225476, author = {Daniel Peck and Ahmed Al-Kaisey}, title = {Cardiac memory: an under-recognised cause of deep T wave inversion in a patient presenting with chest pain}, volume = {2018}, elocation-id = {bcr-2018-225476}, year = {2018}, doi = {10.1136/bcr-2018-225476}, publisher = {BMJ Publishing Group}, abstract = {T wave inversion (TWI) has many differential diagnoses with acute myocardial ischaemia being the highest on the list of potential causes. Cardiac T wave memory is a benign, under-recognised and clinically important phenomenon seen after periods of altered ventricular conduction. After normal ventricular conduction is restored, the T wave {\textquoteleft}remembers{\textquoteright} and mirrors the direction of the wide QRS complex. Therefore, negative T waves are seen in leads that had negative wide QRS complexes. We describe the case of a 60-year-old truck driver with chest pain, deep TWI and traditional cardiovascular risk factors. After ruling out significant myocardial ischaemia, it was crucial to determine the cause of his T wave changes to provide reassurance and provide commercial license medical clearance. While it is currently a diagnosis of exclusion, it remains an important clinical entity for clinicians to recognise to provide an explanation for certain T wave changes to avoid future unnecessary cardiac testing.}, URL = {https://casereports.bmj.com/content/2018/bcr-2018-225476}, eprint = {https://casereports.bmj.com/content/2018/bcr-2018-225476.full.pdf}, journal = {Case Reports} }