What question did this study set out to answer?

To examine the paradoxical normalization of inverted T waves during acute ischemic episodes in patients with preexisting coronary artery disease.

Normalization of abnormal T waves in ischemia

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Why the study?

Does ischemia cause normalization of inverted T waves in patients with coronary artery disease and previous myocardial infarction?

To examine the paradoxical normalization of inverted T waves during acute ischemic episodes in patients with preexisting coronary artery disease.
Monitored electrocardiographic alterations during induced or spontaneous ischemia in a series of 38 patients with coronary artery disease and prior myocardial infarction.
Documented T wave patterns during spontaneous angina pectoris, treadmill exercise provocation, and intravenous isoproterenol hydrochloride infusion.
Inverted T waves normalized to an upright position in 19 patients during spontaneous angina, 11 patients during treadmill exercise, and 8 patients during isoproterenol-induced angina.
The observed normalization reflects the cancellation of preexisting ST depression and inverted T waves by acute ischemia-induced ST elevation and tall T waves, which can obscure expected reciprocal electrocardiographic changes.

Does ischemia cause normalization of inverted T waves in patients with coronary artery disease and previous myocardial infarction?

Population

38 patients with inverted T waves due to coronary artery disease and previous myocardial infarction

Intervention

Ischemia provoked by spontaneous angina pectoris, treadmill exercise, or isoproterenol hydrochloride administration

Outcome

Normalization of inverted T waves to normal, upright positionsurrogate

Inverted T waves due to CAD and prior MI can normalize during acute ischemia, which may mask ischemic ECG changes.

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T-wave normalization may mask ischemic ECG changes in post-MI patients; leaves open diagnostic implications pending prospective validation.

R. J. Noble (1976) studied this question.

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T-wave normalization may mask ischemic ECG changes in post-MI patients; leaves open diagnostic implications pending prospective validation.