T wave inversion on my EKG

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Submitted by Dr T on August 14, 2011 – 2:36pm

Can you please explain what fixed T wave inversion V1-V3 means please. I am 52 years old, fit and well, non-smoker, and I have recently been admitted with chest pain.

Abnormally inverted T waves may be the result of many cardiac and non-cardiac conditions. Sometimes, T wave inversion may a feature of myocardial infarction and angina. If an infarction is not full-thickness of the involved heart muscle wall, then there will be T wave inversion but no Q waves. This condition is described as a subendocardial infarction.

There are two basic types of acute myocardial infarction:

  • Transmural: associated with atherosclerosis caused by high cholesterol levels in your blood involving a major coronary artery. Transmural infarcts extend through the whole thickness of the heart muscle and are usually a result of complete occlusion of the area’s blood supply.
  • Subendocardial: involving a small area in the subendocardial wall (inner layer) of the left ventricle, ventricular septum, or papillary muscles. Subendocardial infarcts are thought to be a result of locally decreased blood supply. The subendocardial area is farthest from the heart’s blood supply and is therefore more susceptible

However, there are other conditions for which you need the interpretation by a doctor.

You can read more about myocardial infarcts and coronary artery disease here:

You can calculate here whether you are at risk:

Hope this helps,
Dr T

(Image from T Wave Abnormalities, Frank G. Yanowitz, MD)

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