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32 Possible Causes for aVR, Impaired Exercise Tolerance, T Wave Inversion

  • Aortic Valve Stenosis

    Patients were grouped into treatment (aortic valve replacement [AVR]) and conservative (non-AVR) groups.[ncbi.nlm.nih.gov] At this point there may be signs of ventricular strain pattern (ST segment depression and T wave inversion) on the EKG, suggesting subendocardial ischemia.[en.wikipedia.org] There remains significant morbidity and mortality associated with AVR, and new techniques and technologies for AVR are being developed.[ncbi.nlm.nih.gov]

  • Heart Valve Disease

    Bioprosthesis AVR plus no risk factor*Aspirin, 80–100 mg/d I AVR plus risk factor*Warfarin, INR 2 to 3 I MVR plus no risk factor*Aspirin, 80–100 mg/d I MVR plus risk factor[ahajournals.org] Transcatheter Pulmonic Valve Implantation (Medtronic MELODY valve) Surgical-based procedures Surgical valve replacement including minimally invasive aortic valve replacement (AVR[heart.ucla.edu] Successful AVR results in substantial clinical and hemodynamic improvement.[ncbi.nlm.nih.gov]

  • Acute Coronary Syndrome

    Small Q waves (ie, 1, V 2, and V 3 ; and lead AVR is often a QS complex normally.[nursingcenter.com] The ECG shows persistent or transient ST-segment depression or T-wave inversion, flat T waves, pseudo-normalisation of T waves, or no ECG changes at presentation.[patient.info] ECG changes such as ST-segment depression, T-wave inversion, or both may be present.[msdmanuals.com]

  • Coronary Atherosclerosis

    New York Heart Association class II-IV), and prediabetes (patients had impaired glucose tolerance and impaired fasting glucose with a balanced profile of obesity and cardiovascular[doi.org] Although most will recognise the typical ECG features of ST elevation myocardial infarction, the significance of ST elevation in lead aVR may not always be appreciated.[ncbi.nlm.nih.gov] […] or appearance or disappearance of localized ST-elevation followed by T-wave inversion in two or more standard electrocardiograph leads; (c) increase in concentration of serum[doi.org]

  • Secondary Cardiomyopathy

    Our patient was noted to have ST-segment elevation in lead aVR, which is associated with global myocardial ischemia and Tako-Tsubo cardiomyopathy.[radcliffecardiology.com] These may include electrocardiogram (ECG) changes of QT prolongation and T wave inversion, elevated biochemical markers of myocardial damage and heart failure, and decreased[link.springer.com] […] with no history of CAD, and frequent T-wave inversion.[aafp.org]

  • Ischemic Cardiomyopathy

    The cardinal manifestations of HF are dyspnea and fatigue, which may limit exercise tolerance, and fluid retention, which may lead to pulmonary congestion and peripheral edema[doi.org] Amplitudes of T/aVR were automatically computed from median ECG beats at enrollment and endpoints were blindly adjudicated.[ncbi.nlm.nih.gov] Definition of HF Heart failure is a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle[doi.org]

  • Chronic Constrictive Pericarditis

    […] demonstrates ST segment depression this lead also may demonstrate PR segment elevation diffuse PR segment depression excluding the aforementioned (lead aVR) later, T wave[radiopaedia.org] […] have Q waves during evolution ST-segment elevation in middle and left precordial leads, but may be widespread Upward convex ST-segment elevation May have T-wave inversion[aafp.org] She then developed insidious progressive impairment in her exercise tolerance.[radcliffecardiology.com]

  • Viral Myocarditis

    Pericarditis on EKG: a diagnosis of exclusion - particularly must exclude ACS Diffuse ST elevations with depressions allowed in V1 or aVR.[hippoed.com] On arrival at the ED a repeat EKG shows some ST elevations in V4-V6, without any reciprocal changes or T wave inversions.[hippoed.com] Exceptions are aVR and V1 where ST depression can be present and normal. Any ST depression in any of the the other 10 leads, cannot be called early repolarization.[hippoed.com]

  • Left Bundle Branch Block

    AIMS: Conventional aortic valve replacement (AVR), sutureless AVR (su-AVR) and transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) are associated[ncbi.nlm.nih.gov] The precordial leads in these patients will demonstrate alarmingly deep, symmetrical T-wave inversions.[ncbi.nlm.nih.gov] His ECG immediately after arrival showed deep T-wave inversion in the precordial leads during normal conduction.[ncbi.nlm.nih.gov]

  • Congenital Aortic Valve Stenosis

    In such situations, the most important concept for treatment is that the procedure should be regarded as a bridge to AVR.[intechopen.com] At this point there may be signs of ventricular strain pattern (ST segment depression and T wave inversion) on the EKG, suggesting subendocardial ischemia.[en.wikipedia.org] inversion of the the T wave, (see figure 24 ) Doppler echocardiography and echocardiography can determine the severity of the stenosis including degree of thickening, calcification[rjmatthewsmd.com]

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