ASSESSING THE CAUSE OF T-WAVE INVERSION IN PRECORDIAL LEADS WITH ECG MAPPING

Inversion of the T wave in precordial leads in patients with angina pe ctoris is a predictor of coronary disease; however, it may also be see n in normal adults. The aim of this study was to assess the cause of T wave inversion by carrying out precordial electrocardiographic (ECG) mapping in 51 patients, who also underwent echocardiography and corona ry angiography. The 37 patients in group A had atypical symptoms. They included 11 patients who showed M pattern mapping, of whom 7 had nonc oronary cardiac disease and 4 were normal. In 23 other group A patient s, whose mappings were in the N pattern, the angiography was normal. I n the remaining three patients of this group, mapping were in the I pa ttern, with angiography revealing coronary disease in two of them and no disease in the third. The 14 group B patients all had typical angin a; mappings were in the I pattern in 8 of the patients and in the N pa ttern in the remaining 6. Angiograplly revealed coronary artery dis ea se in all patients with the I pattern mapping, while all those with th e N pattern were found to be normal. Sensitivity, specificity, and pos itive predictive value for detecting normal subjects were all 100% for N pattern mapping; for detecting coronary disease, they were 100%, 90 %, and 90% for I pattern mapping, respectively. It is concluded that p recordial ECG mapping is an accurate method for the assessment of T wa ve inversion in precordial leads.