Wednesday, June 27, 2018

Inverted U wave

Q: 53 year old male is admitted to ICU after he developed chest pain and shortness of breath at cardiology's office during exercise stress test. EKG during exercise testing showed "reverse/inverted U wave". Which vessel(s) be the most probable culprit?


Answer: left main or left anterior descending (LAD)

Reverse or inverted U wave during stress may be indicative either of volume overload or "tight stenosis" of the left main or left anterior descending (LAD) coronary artery. 


#cardiology



References:

1. Gerson MC, Phillips JF, Morris SN, McHenry PL (1979). "Exercise-induced U-wave inversion as a marker of stenosis of the left anterior descending coronary artery". Circulation. 60: 1014–1020.

2. Conrath C, Opthof T (2005). "The patient U wave". Cardiovasc Res. 67 (2): 184–6.

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