The prominent T wave: electrocardiographic differential diagnosis

Am J Emerg Med. 2002 May;20(3):243-51. doi: 10.1053/ajem.2002.32630.


The prominent T wave is an abnormal T-wave morphology encountered in the earliest phase of ST-segment elevation acute myocardial infarction (AMI). Prominent T waves, however, are associated with other diagnoses, including hyperkalemia, early repolarization, and left ventricular hypertrophy (LVH). This article focuses on the electrocardiographic differential diagnosis of the prominent T wave with the presentation of 4 illustrative cases. We also recommend that the designation hyperacute should refer exclusively to the prominent T waves of ST-segment elevation AMI.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Arrhythmias, Cardiac / diagnosis*
  • Arrhythmias, Cardiac / etiology*
  • Cocaine-Related Disorders / complications
  • Diagnosis, Differential
  • Electrocardiography*
  • Humans
  • Hyperkalemia / diagnosis
  • Hyperkalemia / etiology
  • Hypertrophy, Left Ventricular / diagnosis
  • Kidney Failure, Chronic / complications
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis
  • Pre-Excitation Syndromes / diagnosis
  • Pre-Excitation Syndromes / etiology