T wave

The T wave occurs after the QRS complex and is a result of ventricular depolarization. T waves should be upright in most leads (except aVR and V1). T waves should be asymmetric in nature. The second portion of the T wave should have a steeper decline when compared to the incline of the first part of the T wave. If the T wave appears symmetric, cardiac pathology may be present such as ischemia.


Normal ECG

Many abnormal T wave patterns exist which are listed below with examples when available:

  • Hyperkalemia
  • Wellens syndrome
  • Left ventricular hypertrophy with repolarization abnormalities
  • Pericarditis (Stage III)
  • ARVD
  • Hyperacute T waves
  • Neurologic injury
  • Juvenile T wave
  • QT interval prolongation
  • Hypertrophic obstructive cardiomyopathy