Persistent juvenile T-wave pattern

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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:   

  • Hypokalemia can cause T wave inversion, ST segment depression, QT prolongation, and U wave.

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.[4]
  • Juvenile T wave pattern is more commonly found in females than males. [5][6]

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 [7] Dosage
Oral potassium bicarbonate-citrate 10 gm
Intravenous pro-banthīne 20–30 mg

References

  1. 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.
  2. . doi:10.1136/heartjnl-2018-BCS.71. Missing or empty |title= (help)
  3. Yernault JC, Rocmans P (1986). "[Indications and contraindications for surgery in bronchial cancer]". Rev Med Brux. 7 (8): 459–63. PMID 3797900.
  4. 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.
  5. 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.
  6. 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.
  7. 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