THE SIGNIFICANCE OF NOTCHED UPRIGHT T WAVES

Abstract

A review of the electrocardiogram of 333 patients revealed that notching of T was present in 16%. Notching of T was rare in the limb leads, but of frequent occurrence in the precordial leads, especially in those of children. In the presence of heart disease, T wave notching was observed in the limb leads and more frequently in the chest leads. The commonest cause of notching was coronary insufficiency and/or left ventricular hypertrophy. Notching of T was observed under the same conditions and inversion of T. Both notching and inversion of T may occur in the same lead either simultaneously or in serial tracing during the evolution of a pathological condition. Slurred, flat topped, and triphasic T waves had similar significance. Notching of T must be distinguished from false notching caused by super-imposition of P or U waves on T.