Marked T wave inversion in leads V2-V6 indicates?

Marked T wave inversion in leads V2-V6 indicates?

• A. Acute myocardial infarction
• B. Left ventricular hypertrophy
• C. Wellens syndrome
• D. Coronary artery spasm

Answer: (C)

Marked T wave inversion in leads V2-V6 is most commonly associated with Wellens syndrome, which is a specific pattern of ECG changes that indicates significant stenosis of the proximal left anterior descending artery. This condition is characterized by deep, symmetrical T wave inversions in the anterior leads and can be a precursor to extensive anterior wall myocardial infarction.

Wellens syndrome is critical to recognize because it reflects a high risk for subsequent cardiac events, particularly in patients who have chest pain and exhibit this pattern without Q waves or elevated ST segments. The T wave changes seen in Wellens syndrome can resolve spontaneously but are a sign of underlying ischemia warranting immediate medical intervention.

In contrast, acute myocardial infarction often presents with more pronounced ST segment elevation or depression, while left ventricular hypertrophy is typically characterized by other changes, such as increased amplitude of the QRS complexes and possibly secondary ST and T wave changes. Coronary artery spasm could lead to transient ischemic changes on an EKG, but it doesn't specifically correlate with the prominent T wave inversions seen in leads V2-V6 like Wellens syndrome does. Recognizing these patterns helps in guiding urgent care and management decisions.