{'fraction_non_alphanumeric': 0.019748653500897665, 'fraction_numerical': 0.0017953321364452424, 'mean_word_length': 5.1602209944751385, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Cardiac memory: an under-recognised cause of deep T wave inversion in a patient presenting with chest pain

T wave inversion (TWI) has many differential diagnoses with acute myocardial ischaemia being the highest on the list of potential causes. Cardiac T wave memory is a benign, under-recognised and clinically important phenomenon seen after periods of altered ventricular conduction. After normal ventricular conduction is restored, the T wave ‘remembers’ and mirrors the direction of the wide QRS complex. Therefore, negative T waves are seen in leads that had negative wide QRS complexes. We describe the case of a 60-year-old truck driver with chest pain, deep TWI and traditional cardiovascular risk factors. After ruling out significant myocardial ischaemia, it was crucial to determine the cause of his T wave changes to provide reassurance and provide commercial license medical clearance. While it is currently a diagnosis of exclusion, it remains an important clinical entity for clinicians to recognise to provide an explanation for certain T wave changes to avoid future unnecessary cardiac testing.