Hi all,

I just got an ecg (urgent care, so not read by a cardiologist) that showed peaked t waves in v5, but the overall evaluation was "normal." AI says:

Peaked T waves in lead V5, also known as tall or hyperacute T waves, are a significant finding on an ECG and can indicate a few different conditions, most commonly acute myocardial infarction or hyperkalemia.

Possible Causes of Peaked T Waves in V5:

Hyperkalemia:
. Elevated potassium levels in the blood can cause tall, narrow, and peaked T waves, often accompanied by other ECG changes like a widened QRS complex and a PR interval.

Acute Myocardial Infarction (AMI):
. Early after a heart attack, especially in the leads corresponding to the affected artery (like V5), you may see tall, hyperacute T waves that precede ST-segment elevation. These T waves are usually broader and taller than those seen in hyperkalemia.

Early Repolarization:
. This is a benign condition, sometimes seen in athletes, where the T waves are abnormally tall and upright without other concerning ECG changes.

Left Ventricular Hypertrophy (LVH):
. LVH can cause tall, inverted, or biphasic T waves in leads I, aVL, and V5-V6, along with other ECG signs of LVH, according to ScienceDirect.com.

Other conditions:
. In rare cases, other conditions like diastolic strain or certain conduction abnormalities can also cause tall T waves.


My question is, is this actually significant? Recent blood tests show that my calcium levels are not high. I have asked this question via MyChart, but my EP is out for several weeks and I'm not sure who, if anyone, is answering questions in the interim.

I know that machine-read ecg reports can be inaccurate. And AI responses can be helpful, but also sometimes alarmist. If anyone can weigh in, I would appreciate it!

Sorry, meant to say my potassium levels were not high on my recent bloodwork, not calcium.

"I know that machine-read ecg reports can be inaccurate"

Yes, they often show stuff that is not actually going on. I would ask your EP's medical assistant to have another Dr who might be covering for your vacant EP to read this EKG for you.

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I know that machine-read ecg reports can be inaccurate. And AI responses can be helpful, but also sometimes alarmist

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You pretty much answered your own question here. The peaked T waves in V5 are nothing more than an anomaly unless they come with other findings or symptoms. I would recommend that you quit asking "AI" to interpret your ECGs. They are quite often just plain wrong and even if not wrong, they're usually just textbook answers that can sound alarmist, as you said. I think this is an example of exactly that.

Thanks. Do you know how sometimes you just need another human being to say “yeah, that’s nothing to be concerned about”? Especially with no EP or substitute readily available. Right now the internet and this forum are my only resources.

Yep, I get it, and that's why this forum is still here and always will be as long as Shannon and I can keep the lights on.