Giant T Wave Inversion D

The genesis of the T wave of the electrocardiogram is ill understood. It represents ventricular repolarization, and is thus dependent on changes occurring at cell membrane level. It is the most labile component of the QRST complex and is affected by many physiol6gical, neuro-humoral, and physical factors in health, as well as being the most sensitive index of disease. One of the most interesting and least understood deformities is that of massive enlargement of the T wave, in which the T wave is grotesquely blown up, often inverted, and covers an area many times that of the QRS complex. Coronary artery disease has often been implicated, especially when the T waves are deeply inverted (Garcia-Palmieri et al., 1956; Ippolito, Blier, and Fox, 1954; Silverman and Goodman, 1949; Pruitt, Klakeg, and Chapin, 1955; Wood and Wolferth, 1934; Fisch, 1961; Costanzo, de la Pierre, and Pietra, 1962), but coronary disease is probably not basically responsible when the deformity is gross. Ippolito et al. (1954) first drew attention to the occurrence of massive T wave inversion with complete heart block, and this observation has been confirmed by others (Pfeferman, Chansky, and Feher, 1960; Szilagyi and Solomon, 1959; Jedlicka and Panos, 1962; Birke and Strom, 1955; Holzmann, 1960; Zoob and Smith, 1963).