Giant T Wave Inversion: Cerebral Hæmorrhage

Report:

Sinus rhythm

Left anterior hemiblock

Giant T wave inversion

Comment:

The patient, ever more rousable, started complaining of severe headache and a lumbar puncture136 showed blood and xanthochromia; she was transferred to the ICU. It is not an isolated instance of the ECG directing the diagnosis away from the brain137.

The phenomenon is discussed further in her and another patient’s case report138.

The original ECG , taken on admission the previous day, looked infarctional (190a) and was responsible for her admission to CCU. It suggested an old and recent anterior infarction even though the reciprocal changes were missing.

Further evolution was equally indistinguishable from evolving MI (190b), although its deep, symmetrical T inversion was global. The LAHB persisted throughout.

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