What illness does an abnormal T wave on a physical examination ECG indicate?

T-wave abnormalities on routine physical examination electrocardiograms (ECG) may result from physiological factors, or may be caused by pathological conditions such as myocardial ischemia or coronary atherosclerotic heart disease. Specific details are as follows:

I. Physiological Causes

T-wave abnormalities may occur in daily life due to excessive mental stress, anxiety, fatigue, and insufficient sleep. They can also appear when the sympathetic nervous system is stimulated by frequent consumption of strong tea, coffee, or similar substances.

II. Pathological Causes

1. Myocardial Ischemia
This is a cardiac condition caused by inadequate blood supply to the heart muscle. The ECG may show low, flattened T waves or symmetrically inverted T waves. Some patients may also exhibit ST-segment depression.

2. Coronary Atherosclerotic Heart Disease
This refers to heart disease caused by atherosclerosis of the coronary arteries leading to myocardial ischemia. ECG findings may include T-wave inversion and ST-segment depression.

In addition to the above common causes, other possible conditions include pericarditis, cerebral hemorrhage, and pre-excitation syndromes. If any symptoms occur, it is recommended to seek timely medical evaluation and treatment.