Persistent juvenile T-wave pattern: Difference between revisions
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==Natuarl History, Complications, Prognosis== | ==Natuarl History, Complications, Prognosis== | ||
Juvenile T-wave resolves completely in 98% of the | Juvenile T-wave resolves completely in 98% of the patients with 2 years, and the cases that persist into adulthood demonstrate no adverse sequela.<ref>{{cite journal|doi=10.1136/heartjnl-2018-BCS.71}}</ref> | ||
== Differentiating persistent Juvenile T-wave pattern from other causes of T-wave inversion == | == Differentiating persistent Juvenile T-wave pattern from other causes of T-wave inversion == | ||
Revision as of 05:00, 1 March 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: Juvenile T waves
Overview
The Juvenile T-wave pattern refers to a normal electrocardiographic variant in which T wave inversions are present in precordial leads V1, V2, and V3 along with an early repolarization pattern. Shallow T-wave inversion is usually found in the right precordial leads (V1-V3) during infancy. T wave then rises upwards during childhood. If this inverted T-wave pattern sustained to adulthood, it is called persistent juvenile T-wave pattern.
Natuarl History, Complications, Prognosis
Juvenile T-wave resolves completely in 98% of the patients with 2 years, and the cases that persist into adulthood demonstrate no adverse sequela.[1]
Differentiating persistent Juvenile T-wave pattern from other causes of T-wave inversion
Persistent juvenile T-wave inversion must be differentiated from other diseases that cause T-wave inversion, such as:
- Arrhythmogenic RV dysplasia should be suspected in this cohort if the T wave inversion persists beyond lead V1 in a post pubertal male athlete
- Cerebrovascular accidents can cause deep widely splayed T waves referred to as cerebral T waves
- Ischemic heart disease including non ST segment elevation MI or prior MI
- Left bundle branch block, it is normal for the T wave to be inverted if the QRS complex is upright
- Pulmonary embolism, particularly in the anterior precordium
Epidemiology and Demographics
- Juvenile T wave pattern is more commonly seen in black people—it has been shown in 10.8% of black population and 0.3% of white subjects.[2]
Diagnosis
Electrocardiogram
Juvenile T wave pattern typically shows asymmetric T wave inversion in V1-V3 without ST segment elevation.
Electrocardiogram Examples
Treatment
Juvenile T wave pattern can be normalized by the following medications:
| Medications [5] | Dosage |
|---|---|
| Oral potassium bicarbonate-citrate | 10 gm |
| Intravenous pro-banthīne | 20–30 mg |
References
- ↑ . doi:10.1136/heartjnl-2018-BCS.71. Missing or empty
|title=(help) - ↑ Wasserburger, Richard H. (1955). "Observations on the "juvenile pattern" of adult Negro males". The American Journal of Medicine. 18 (3): 428–437. doi:10.1016/0002-9343(55)90223-0. ISSN 0002-9343.
- ↑ Assali AR, Khamaysi N, Birnbaum Y (1997). "Juvenile ECG pattern in adult black Arabs". J Electrocardiol. 30 (2): 87–90. doi:10.1016/s0022-0736(97)80014-3. PMID 9141601.
- ↑ Ashcroft, M.T.; Miller, G.J.; Beadnell, H.M.S.G.; Swan, A.V. (1971). "A comparison of T-wave inversion, S-T elevation, and RS amplitudes in precordial leads of Africans and Indians in Guyana". American Heart Journal. 81 (4): 467–475. doi:10.1016/0002-8703(71)90360-7. ISSN 0002-8703.
- ↑ WASSERBURGER RH (1955) Observations on the juvenile pattern of adult negro males. Am J Med 18 (3):428-37. DOI:10.1016/0002-9343(55)90223-0 PMID: 14349968