Isolated U Wave Inversion

Report:

Sinus rhythm 82/min

Nonspecific T wave changes

T3 > T1, TV1 > TV6, consistent with ischæmia

Negative U waves

Comment:

U waves are common; their isolated (from the T wave) negativity is rare and constitutes a surprisingly specific marker of the LAD artery (the artery of sudden death) disease. They are best seen here in leads V4 and V5.

This patient had no autopsy; my report of this ECG described enough coronary disease for the patient’s physician to issue a Death Certificate. I remonstrated, pointing out that even the cause of her jaundice remained undiagnosed. He said her family did not want a post mortem - we had no right to inflict it on them. As I grew older and, possibly, wiser, I came to agree with him51.

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