OBJECTIVES: 1. To report cases of "normal", asymptomatic, young, pre-employment males without significant cardiovascular risk factors but with electrocar diographic (ECG) T-wave inversion in multiple leads; and 2. To emphasize the importance of overall clinical correlation in interpretation of the ECG and in overall diagnostic and management decisions.
SETTING: Outpatient urban pre-employment clinic
CASE SUMMARY: Seven young (44 years of age), pre-employment, asymptomatic, male cases with resting ECG findings of T-wave inversion in multiple leads but with normal physical, radiographic, and cardiosonographic cardiac anatomy are herein reported. All cases did not have significant cardiovascular risk factors and were able to uneventfully hurdle at least 9 METs of monitored treadmill exercise. All cases were eventually cleared for employment and presumably enjoying a productive life; nobody among them was repatriated.
CONCLUSION: Clinical presentation is the more important arbiter of cardiovascular/physical fitness than any isolated ECG finding.