The U waves
Let’s talk about U waves.
The U wave is a deflection (usually small) immediately following the T wave.
The U wave is usually absent. When is present, it’s best seen in V2-V3.
The U wave can be:
✅ Positive: upright with amplitude <1.5 mm.
✅ Prominent: upright with amplitude >1.5 mm.
✅ Inverted or negative.
Positive (upright) U wave
Causes of prominent U wave include: hypokalemia, antiarrhythmic drugs, bradyarrhythmias, hypothermia, hypocalcemia, coronary artery disease, MI, others.
Prominent U wave
Causes of inverted U wave include: myocardial ischemia, LVH, RVH, anoxic brain injury. Exercise-induced inversion of the U-wave is highly predictive of significant coronary artery disease, others.
Inverted (negative) U wave
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