This ECG was obtained from a man in his 70’s. We have no other clinical information. It is interesting for several reasons.
Giant T wave inversionsThe most obvious abnormalities we see on first inspection are the deeply inverted T waves in Leads V3 through V6. The T wave in V3 is biphasic. There are also T wave inversions in all of the limb leads except aVR. The precordial T wave inversions are called “giant T wave inversions” because they are 10 mm or more in depth. There are many causes of giant T wave inversions, including, but not limited to: myocardial ischemia, coronary artery disease and reperfusion, pulmonary edema, massive pulmonary embolism, subarachnoid hemorrhage, apical hypertrophy, post-tachycardia syndrome, and post-pacing syndrome.
What else? There are no Q waves or ST elevations. The ST segments are not entirely normal in shape, being flattened in most lead. The frontal plane axis is left. Even though the ECG almost meets criteria for left ventricular hypertrophy, by exclusion we would call this anterior fascicular block (left anterior hemiblock). Obviously, it would help greatly if we had some history and clinical information to accompany this ECG.