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In looking at the T wave, there are a few points to memorise:

  1. The T wave is usually symmetrical. If not beware that there isn’t a p wave in the ecg.
  2. The peaked T wave can represent hyperkalaemia or ischaemia. If the T wave is approaching or has passed the hight of the T wave in V4, consider arrhythmia.
  3. Inverted T waves may represent ischaemia or a recent infarction, pulmonary embolism or raised intracranial pressure. They may also be part of left ventricular hypertrophy.
  4. Look for the u wave after the T wave. This is usually prominent in hypokalaemia and inverted (i.e.., opposite director )
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