Key result
Isolated U wave inversion in leads I, V4, and V5 during chest pain indicated a 99% stenosis of the left main coronary artery in a patient with unstable angina.
Isolated U wave inversion during chest pain can be a sign of severe left main coronary artery stenosis.
May prompt angiography in select unstable angina cases; single observation leaves open the diagnostic value of isolated U-wave inversion.
A 50-year-old male was admitted to hospital for repeated episodes of chest pain due to unstable angina. Serial electrocardiograms were all normal except for one electrocardiogram, recorded during chest pain, which showed isolated U wave inversion in leads I, V4 and V5. Subsequently, selective coronary arteriography showed isolated 99% stenosis of his left main coronary artery.
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Chia et al. (2008) studied this question. Isolated U wave inversion in leads I, V4, and V5 during chest pain indicated a 99% stenosis of the left main coronary artery in a patient with unstable angina.
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