Persistent juvenile T-wave pattern: Difference between revisions
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=== Electrocardiogram === | === Electrocardiogram === | ||
Juvenile T wave pattern typically shows asymmetric T wave inversion in V1-V3 without ST segment elevation. | Juvenile T wave pattern typically shows asymmetric T wave inversion in V1-V3 without ST segment elevation. | ||
== Treatment == | == Treatment == | ||
Juvenile T wave pattern can be normalized by the following medications: | Juvenile T wave pattern can be normalized by the following medications: | ||
Revision as of 02:35, 4 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.
Historical Perspective
The term Juvenile T-wave pattern was first introduced by American physician David Littman in 1946. [1]
Natural 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.[2]
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.[3]
Diagnosis
Electrocardiogram
Juvenile T wave pattern typically shows asymmetric T wave inversion in V1-V3 without ST segment elevation.
Treatment
Juvenile T wave pattern can be normalized by the following medications:
| Medications [6] | Dosage |
|---|---|
| Oral potassium bicarbonate-citrate | 10 gm |
| Intravenous pro-banthīne | 20–30 mg |
References
- ↑ LITTMANN D (1946). "Persistence of the juvenile pattern in the precordial leads of healthy adult Negroes, with report of electrocardiographic survey on three hundred Negro and two hundred white subjects". Am Heart J. 32: 370–82. doi:10.1016/0002-8703(46)90797-1. PMID 20996765.
- ↑ . 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