Usefulness of Decreasing Number of Negative T Wave Leads on Electrocardiography for Predicting the Improvement of Pulmonary Hypertension

A Case Report

Abstract

A 75-year-old woman presented with loss of consciousness to our hospital. Her electrocardiogram on admission showed negative T waves in III, aVF, and V_1～5 leads. Echocardiography indicated pulmonary hypertension with estimated right ventricular systolic pressure (RVSP) of 58 mmHg. Contrast-enhanced computed tomography showed the presence of a left pulmonary artery thrombus. Therefore intravenous anticoagulant therapy was started and the RVSP gradually reduced to 42 mmHg at 45 days after admission. With the reduction of RVSP, the negative T waves of the chest leads gradually disappeared from the left-sided leads to the right-sided ones on the horizontal plane of chest leads, whereas those of the limb leads gradually disappeared from the leftward axis of aVF (+90°) to the rightward ones of III (+120°). These findings suggest that the disappearances of negative T waves from left to right leads may result from the decreased right heart overload.