T wave abnormalities identify patients with previous lateral wall myocardial infarction and circumflex artery disease

Abstract Background The diagnosis of previous lateral myocardial infarction is based on QRS morphology. Objectives To explore the diagnostic role of T wave abnormalities. Methods We studied 166 patients with known or suspected ischemic heart disease who underwent a 12-lead electrocardiogram, myocardial perfusion scintigraphy, and coronary arteriography within 90 days. We excluded patients with bundle-branch block, hypertrophy, or paced rhythm. Results Only one patient had a prominent R wave in V 1 , no patient showed lateral Q waves of necrosis. T wave amplitude in V 2 –V 6 ≥ 0.6 mV, and T wave amplitude in lead 1 + V 6 ≤ 0 mV detected a lateral infarction (sensitivity 33 and 44%, specificity 83 and 80%). T wave amplitude in lead 1 + V 6 ≤ 0 mV was the only independent predictor of infarction or LCx occlusion (AUC 0.72 and 0.74). Serum potassium values were not associated with T wave abnormalities. Conclusion T wave abnormalities identify previous lateral infarction and LCx disease.