Inverted T wave after SVT

[Sandy]

This is for all of you electrophysiology cardiologists or general
cardiologists:

After a run of sinus arrhythmia is it normal to have an
inverted T wave for up to 8 hours on an ekg? Is the inverted
T wave always a sign that there is a blockage or can the
stress of the SVT also cause this?

[Terrence Chun]

bluesandybaby@yahoo.com (Sandy) wrote in
news:5678d904.0406271216.363b621d@posting.google.com:

> After a run of sinus arrhythmia is it normal to have an
> inverted T wave for up to 8 hours on an ekg? Is the
> inverted T wave always a sign that there is a blockage or
> can the stress of the SVT also cause this?

It is not uncommon to see T wave changes during SVT, but
these typically return to normal with resumption of
sinus rhythm.

What do you mean by "a run of sinus arrhythmia"? Most people
experience sinus arrhythmia constantly as normal. No T wave
changes, in the absence of ischemia.

- TC, md Pediatric cardiology and electrophysiology

[Dr. Andrew B. C]

Sandy wrote:
>
> This is for all of you electrophysiology cardiologists or
> general cardiologists:
>
> After a run of sinus arrhythmia is it normal to have an
> inverted T wave for up to 8 hours on an ekg?

Depends on how fast the SVT was and one doesn't really ever
characterize persistently inverted T waves as "normal."

> Is the inverted T wave always a sign that there is a
> blockage or can the stress of the SVT also cause this?

I have seen persistently inverted T waves after an SVT lead
to a negative work-up for occlusive coronary disease.

Servant to the humblest person in the universe,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/

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[Sandy]

"Dr. Andrew B. Chung, MD/PhD" <andrew@heartmdphd.com> wrote in message news:<40E14171.65C@heartmdphd.com>...

Hey guys, thanks for answering. What I mean is... a rapid
sinus arrhythmia of about 178 that lasted for 25 minutes
with the blood pressure bottoming out to 70 over 40 and then
the T wave being inverted for about 8 hours after that.

The sinus tachycardia was 1 on 1 with some PVC's tossed in,
but it was a run away freight train, a neurocardiogenic
episode of sorts. I had already had a correction for AV node
re-entrant tachy via open heart cryoblation (back in the
dinosaur ages), then a modified radio-frequency albation for
atrial flutter (caused from scarring, and then an on demand
dual lead Discovery DDD pacer put in, non pacer dependent,
and now here I am hating these runs of tachy). (Oh, I'll
also add that my atrial septum was ruptured during pacer
insertion and it created a bulbing anyerism that was
shunting but it recently healed on its own)

So, if I go into the aflutter I stop on my own but sometimes
continue forward in this run away train sinus arrhythmia.
Sometimes I have an inverted T wave for 8 hours but all
tests come back as negative for heart attack, and all stress
tests, profusion stress tests come back normal as well
except for high counts of PVC's during stress.

Have you seen this before or am I doomed to be the most
bizarre cardiac case in electrophysiology history?! Ug. I
will say this, for all the blessing of being a "first",
being a guinea pig has made it awfully lonely regarding
knowing what others go through. Sometimes I'd like some
company just to compare notes.

[Dr. Andrew B. C]

Sandy wrote:
>
> "Dr. Andrew B. Chung, MD/PhD" <andrew@heartmdphd.com>
> wrote in message news:<40E14171.65C@heartmdphd.com>...
>
> Hey guys, thanks for answering.

The glory is all His :-)

> What I mean is... a rapid sinus arrhythmia of about 178
> that lasted for 25 minutes with the blood pressure
> bottoming out to 70 over 40 and then the T wave being
> inverted for about 8 hours after that.

Sounds like the T wave changes may certainly have been from
inadequate myocardial perfusion secondary to hemodynamic
instability.

> The sinus tachycardia was 1 on 1 with some PVC's tossed
> in, but it was a run away freight train, a
> neurocardiogenic episode of sorts. I had already had a
> correction for AV node re-entrant tachy via open heart
> cryoblation (back in the dinosaur ages), then a modified
> radio-frequency albation for atrial flutter (caused from
> scarring, and then an on demand dual lead Discovery DDD
> pacer put in, non pacer dependent, and now here I am
> hating these runs of tachy). (Oh, I'll also add that my
> atrial septum was ruptured during pacer insertion and it
> created a bulbing anyerism that was shunting but it
> recently healed on its own)
>
> So, if I go into the aflutter I stop on my own but
> sometimes continue forward in this run away train sinus
> arrhythmia. Sometimes I have an inverted T wave for 8
> hours but all tests come back as negative for heart
> attack, and all stress tests, profusion stress tests come
> back normal as well except for high counts of PVC's
> during stress.
>
> Have you seen this before or am I doomed to be the most
> bizarre cardiac case in electrophysiology history?!

The former.

> Ug. I will say this, for all the blessing of being a
> "first", being a guinea pig has made it awfully lonely
> regarding knowing what others go through. Sometimes I'd
> like some company just to compare notes.

You are not alone either physically or spiritually.

Servant to the humblest person in the universe,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/

**
Who is the humblest person in the universe?
http://makeashorterlink.com/?L26062048

What is all this about?
http://makeashorterlink.com/?R20632B48

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http://makeashorterlink.com/?N69721867