Nitroglycerin-Induced Giant T Wave Inversion

Report:

Sinus rhythm

Giant T wave inversion[!xe "T wave:inversion:giant:anginine syncope" \b \i!][!xe "Giant T wave inversion" \t "See T wave" \b \i!]

Comment:

As in the case of global T wave inversion, it is best to leave the report at that. I came to see this patient after reporting her ECG. She stated that, in her GP’s surgery, she felt anginal pain130 and took an Anginine. This made her completely lose power in her limbs and she almost fell into a chair. She does not recall any loss of consciousness, although she may have remained unaware of a syncope lasting only few seconds. The giant inversion is virtually pathognomonic of a preceding faint: this is the only case I’ve seen where syncope could not be confirmed with certainty.

She was next admitted to CCU (largely because of her admission ECG), but no evidence of infarction was obtained. The ECG normalised within days (Fig 174a).

It appears that geriatric patients may be - not surprisingly - sensitive to nitroglycerin131.[!xe "Nitroglycerin:giant T wave inversion" \b \i!]

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