Report:

Sinus rhythm.

Left atrial abnormality .

Left ventricular hypertrophy with ST/T changes.

Comment:

Theoretically, the LAA and the ST/T changes could be a consequence of previous tachyarrhythmia (the "post-tachycardia syndrome"), and the LVH could be spurious, left to depend, as it were, on the precordial voltage criteria alone. The overall changes present are, however, too striking for that.

HOCM is one of the "usual suspects" for the sudden death "syndrome" (SDS) in young subjects. In this case it was diagnosed echocardiographically.

The problem continues to attract interest158,159.

Truncal Vagotomy and the T Wave

Report:

Sinus ? atrial rhythm.

Borderline left axis deviation -30o

LVH voltage.

Incomplete RBBB.

Non-specific ST/T changes.

Comment:

The ST/T changes are non-specific (they always are) but the "widely splayed" T wave inversion, most marked in anteroseptal leads, with prolonged QT interval, is unusual. In the absence of other ascertainable causes, truncal vagotomy appears responsible160.

On the other hand, there are at least 3 cases of T wave inversion following general anæsthesia in this Library alone. It could well be that GA, rather than truncal vagotomy, inverted the T waves.