Swinging T Waves

Report:

Sinus rhythm.

Incomplete RBBB.

Respiratory phasic reversal of T wave polarity.

Comment:

In the right precordial leads, respiratory movement has at times striking effect on the T wave and, less often, the QRS complex itself. This may of clinical importance when only a few cycles are sampled in a routine 12-lead ECG. It does happen: see Case 212.

The phenomenon is common and should be well known to ECG technicians. It appears less well known to the editors of the Chest, who actually published a report on “an unusual cause of electrical alternans”200. Alternans! Before long the language will have no specificity.

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