"Coronary" T waves in the presence of complete left bundle-branch block: a normal variant?

The case report of a patient with an ECG pattern of intermittent left bundle-branch block, presenting inverted and symmetric ("coronary") T waves in leads V1 to V3 during periods of normal intraventricular conduction, is presented. The patient was followed up for eight years during which time no relevant symptoms appeared while extensive noninvasive investigations repeatedly failed to reveal any organic basis for the ECG changes. It is stressed that inverted, symmetric T waves in right-sided chest leads may be encountered in young, otherwise healthy subjects with intermittent left bundle-branch block during periods of normal intraventricular conduction. Knowledge of this fact is important in order to avoid iatrogenic cardiac invalidism in such cases.