The U-wave: A remaining enigma of the electrocardiogram

Kihlgren, Moa; Almqvist, Christina; Amankhani, Fereydoun; Jonasson, Linda; Norman, Cecilia; Pérez, Marcos; Ebrahimi, Ahmad; Gottfridsson, Christer

doi:10.1016/j.jelectrocard.2023.03.001

Cited by 2 publications

(2 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…6 It has been described in a few case reports that inverted U-waves might precede the typical electrocardiographic changes of myocardial infarction by several hours. 7 Studies have also shown that, after successful revascularization, the inverted U-waves have disappeared. This association provides further support that the inverted U-waves are associated with cardiac ischemia.…”

Section: Discussionmentioning

confidence: 99%

“…In the early phase of myocardial ischemia that is associated with coronary vasospasm or exercise-induced ischemia, a transient U-wave inversion may occur . It has been described in a few case reports that inverted U-waves might precede the typical electrocardiographic changes of myocardial infarction by several hours . Studies have also shown that, after successful revascularization, the inverted U-waves have disappeared.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Inverted U Waves—Red Flags in Electrocardiograms

2023

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Inverted U Waves—Red Flags in Electrocardiograms

2023

View full text Add to dashboard Cite

show abstract

Cardiac repolarization abnormalities and neurally mediated syncope: overlooked aspects in the diagnosis of pheochromocytoma

Cotias,

Neto,

Gomes

et al. 2024

Int J Arrhythm

View full text Add to dashboard Cite

Background Pheochromocytoma is a rare catecholamine-producing tumour originating from adrenal chromaffin cells. Classic clinical presentation includes headache, diaphoresis and palpitation. Syncope is uncommon and may result from hypotension or arrhythmia. We report a case of neurally mediated syncope in pheochromocytoma associated with cardiac repolarization abnormalities, a unique presentation of the disease. Case presentation This case report presents a 28 year-old woman, describing recurrent syncope usually preceded by prodromes such as headache, visual blurring, heart palpitations and psychomotor agitation. Firstly she was diagnosed with anxiety and depression, but there was no improvement of symptoms with psychiatric treatment. Previous Holter revealed long QT interval. Echocardiogram showed normal dimensions, preserved left ventricular function and no valvopathies. The patient was referred for a Head-up tilt test (HUTT) in order to investigate reflex syncope. The electrocardiogram (ECG) exhibited normal sinus rhythm and diffuse cardiac repolarisation abnormalities. HUTT was positive for vasodepressor type neurally mediated syncope and ECG showed U waves after a syncope episode. This electrocardiographic finding motivated further clinical investigation. The patient also described abdominal pain, increased abdominal volume, weight loss and blood pressure instability. Based on clinical history and ventricular repolarisation abnormalities uncovered by HUTT, pheochromocytoma was suspected. Urinary test was positive for catecholamines and the abdominal imaging revelead expansive lesion. She underwent surgery to remove the pheochromocytoma, confirmed by immunohistochemistry. Conclusions After surgery she had no recurrency of symptoms, remaining asymptomatic after six years of follow-up, suggesting a cause-effect relationship between neurally mediated syncope and pheochromocytoma.

show abstract

The U-wave: A remaining enigma of the electrocardiogram

Cited by 2 publications

References 45 publications

Inverted U Waves—Red Flags in Electrocardiograms

Inverted U Waves—Red Flags in Electrocardiograms

Cardiac repolarization abnormalities and neurally mediated syncope: overlooked aspects in the diagnosis of pheochromocytoma

Contact Info

Product

Resources

About