Isolated T Wave Inversion in Lead aVL: An ECG Survey and a Case Report

Emergency Medicine International. 2015;2015 DOI 10.1155/2015/250614

 

Journal Homepage

Journal Title: Emergency Medicine International

ISSN: 2090-2840 (Print); 2090-2859 (Online)

Publisher: Hindawi Limited

LCC Subject Category: Medicine: Internal medicine: Medical emergencies. Critical care. Intensive care. First aid

Country of publisher: United Kingdom

Language of fulltext: English

Full-text formats available: PDF, HTML, ePUB, XML

 

AUTHORS

Getaw Worku Hassen (Lutheran Medical Center, Department of Emergency Medicine, Brooklyn, NY 11220, USA)
Ana Costea (NYMC, Metropolitan Hospital Center, Department of Emergency Medicine, New York, NY 10029, USA)
Claire Carrazco (School of Osteopathic Medicine, A.T. Still University, Mesa, AZ 85206, USA)
Tsion Frew (Bellevue Medical Center, Department of Emergency Medicine, New York, NY 10016, USA)
Anand Swaminathan (Bellevue Medical Center, Department of Emergency Medicine, New York, NY 10016, USA)
Jason Feliberti (Department of Internal Medicine, NYU, New York, NY 10016, USA)
Roger Chirurgi (NYMC, Metropolitan Hospital Center, Department of Emergency Medicine, New York, NY 10029, USA)
Tennyson Smith (Medgar Evers College, Brooklyn, NY 11225, USA)
Alice Chen (School of Osteopathic Medicine, A.T. Still University, Mesa, AZ 85206, USA)
Sarah Thompson (Lutheran Medical Center, Department of Family Practice, Brooklyn, NY 11220, USA)
Neola Gushway-Henry (Lutheran Medical Center, Department of Family Practice, Brooklyn, NY 11220, USA)
Bonnie Simmons (Lutheran Medical Center, Department of Emergency Medicine, Brooklyn, NY 11220, USA)
George Fernaine (Lutheran Medical Center, Department of Internal Medicine, Brooklyn, NY 11220, USA)
Hossein Kalantari (NYMC, Metropolitan Hospital Center, Department of Emergency Medicine, New York, NY 10029, USA)
Soheila Talebi (NYMC, Metropolitan Hospital Center, Department of Internal Medicine, New York, NY 10029, USA)

EDITORIAL INFORMATION

Blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 17 weeks

 

Abstract | Full Text

Background. Computerized electrocardiogram (ECG) analysis has been of tremendous help for noncardiologists, but can we rely on it? The importance of ST depression and T wave inversions in lead aVL has not been emphasized and not well recognized across all specialties. Objective. This study’s goal was to analyze if there is a discrepancy of interpretation by physicians from different specialties and a computer-generated ECG reading in regard to a TWI in lead aVL. Methods. In this multidisciplinary prospective study, a single ECG with isolated TWI in lead aVL that was interpreted by the computer as normal was given to all participants to interpret in writing. The readings by all physicians were compared by level of education and by specialty to one another and to the computer interpretation. Results. A total of 191 physicians participated in the study. Of the 191 physicians 48 (25.1%) identified and 143 (74.9%) did not identify the isolated TWI in lead aVL. Conclusion. Our study demonstrated that 74.9% did not recognize the abnormality. New and subtle ECG findings should be emphasized in their training so as not to miss significant findings that could cause morbidity and mortality.