• The T wave on an ECG indicates the direction of the wave of repolarisation back to the resting state membrane potential of the conducting cells of the heart. An inversion of the T wave does not always indicate an MI has occurred, as other causes exist, such as electrolyte disturbances and pharmacological effects (such as digitalis use) amongst other causes. However, inversion of the T wave is a common finding in patients after the early acute phase of an MI, which may resolve with time or persist indefinitely. The T wave inversion indicates ischaemic damage and possible necrosis/fibrosis of the affected tissue. The damaged tissue cannot repolarise as the healthy tissue can due to the loss in membrane potential regulation (the cells are too damaged to be able to transmit the electric current correctly) so that the wave of repolarisation following contraction of the heart is disrupted.

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