Indeed, careful examination of the resting ECG (Figure 2) reveals T-wave inversion (grey arrows) without ST-segment depression but with early repolarisation in Leads V2-V4 (black arrows).
If it had been requested, pre-existing T-wave inversion in the inferolateral leads would have been observed and resulted in further investigation prior to general anaesthesia.
Caption: Figure 2: 12-Lead electrocardiogram four hours post-procedure demonstrating T-wave inversion in the inferolateral leads (grey arrows), with ST segment elevation in V2-V4 (black arrows) and voltage criteria for left ventricular hypertrophy.
The Table lists other causes of global T-wave inversion (1-5).
Some causes of global T-wave inversion Myocardial ischemia Intracranial hemorrhage Other central nervous system disease Pericarditis Myocarditis Hypertrophic cardiomyopathy Stress-induced myocardial stunning Metabolic abnormalities Cocaine use Pheochromocytoma Nonischemic pulmonary edema High-grade atrioventricular block Aftereffect of cardiac arrest Cardiac metastases