Electrocardiographic T- and U-Wave Discordance

Background: Abundant information has been reported regarding the U wave, which almost entirely has been focused on U waves in isolation. There has been little investigation of discordant T and U waves. Methods: Of 18,750 consecutively recorded electrocardiograms, 143 patients were categorized resulting in three groups. Group A: 53 patients with negative T waves and positive U waves (Type I Discordance); Group B: 26 patients with positive T waves and negative U waves (Type II Discordance); and Group C: 63 patients with negative T and negative U waves. Each patient's chart was reviewed for relevant clinical, laboratory, and medical history. Results: Coronary disease was slightly more common in Group A (64%) than in Group B (46%) (P = 0.174; ns). Coronary disease in Group C was extremely common (88%; P