PMC4407619_01
Dynamic T wave changes on ECG. (a) Upright T wave in lead aVL (black arrows, old ECG); (b) T wave flattening and early inversion in lead aVL (orange arrows, ECG at presentation); (c) TWI in lead aVL (red arrows, repeat ECG) and biphasic T waves in leads V2 and V3 (green arrows).
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fig3
T wave flattening in lead aVL (Figure 3(b)). The chest radiography was unremarkable. The repeat ECG showed sinus rhythm at 62 beats per minute with TWI in lead aVL along with biphasic T waves in leads V2 and V3 (Figure 3(c)). T wave in lead aVL (Figure 3(a)). The patient was taken to the angiography suite and underwent a coronary angiogram.
Coronary angiography. (a) Mid-LAD lesion (red arrow) and no proximal LAD abnormality: (b) after placement of stent.
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fig4
Angiography revealed a 99% mid-LAD lesion and he received a stent (Figures 4(a) and 4(b)).
Follow-up ECG: patient returned to the cardiology office and his repeat ECG demonstrated the upright T waves in lead aVL after the stent placement.
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fig5
He remained symptom-free and on the follow-up clinic visit his ECG normalized with upright T waves in lead aVL (Figure 5).