Clinical Dilemma - Cardiac Memory vs Myocardial Ischemia

Rastko Rakočević; Renjit Thomas; Ralph G Oriscello

doi:10.7759/cureus.7129

Clinical Dilemma - Cardiac Memory vs Myocardial Ischemia

Cureus. 2020 Feb 28;12(2):e7129. doi: 10.7759/cureus.7129.

Authors

Rastko Rakočević^{1

2}, Renjit Thomas³, Ralph G Oriscello⁴

Affiliations

¹ Internal Medicine, University Hospital - Rutgers New Jersey Medical School, Newark, USA.
² Pulmonary and Critical Care Medicine, University of Southern California, Los Angeles, USA.
³ Cardiology, University Hospital - Rutgers New Jersey Medical School, Newark, USA.
⁴ Cardiology/Critical Care, Veterans Affairs (VA) East Orange/Rutgers New Jersey Medical School, East Orange, USA.

Abstract

Cardiac memory (CM) is a commonly unrecognized entity in which electrocardiograph (EKG) changes demonstrate T wave inversions (TWI) that appear consistent with ischemia. Inability to recognize and distinguish CM from actual ischemia can be a burden for both patients and hospitals, leading to unnecessary hospital admission, cardiac testing, and cardiac catheterization. Simple EKG analysis and meticulous interpretation of T-wave axis and morphology can help differentiate between the two. We present a case with such a dilemma, and an overview literature and physiology behind this entity.

Keywords: cardiac memory; critical care; ischemia; ischemia trial; pacemaker; t wave inversion; twi.

Publication types

Case Reports