# Isquemia subepicárdica | Subepicardial ischemia

# Definição | Definition

<span data-sheets-root="1">Ondas T negativas, simétricas e pontiagudas com amplitude maior ou igual a 5 mm em pelo menos duas derivações contíguas</span>

*<span data-sheets-root="1">Negative, symmetrical and pointed T waves with an amplitude greater than or equal to 5 mm in at least two contiguous leads</span>*

# Exemplo | Examples

- Exemplo 1 | Example #1

Paciente do sexo feminino, 48 anos, com relato de dispneia, dor torácica, palpitações, náuseas, vômitos e sudorese e histórico de HAS e de infarto prévio. Em uso de enalapril, sinvastatina e hidroclorotiazida. Ao ECG, apresenta ritmo sinusal regular com frequência cardíaca de 61 bpm. Percebe-se onda T negativa, simétrica e pontiaguda com amplitude maior ou igual a 5 mm nas derivações DI, DII, aVL, V2, V3, V4, V5 e V6. Indica **isquemia subepicárdica** e possível doença arterial coronariana.

*A 48-year-old female patient presenting with dyspnea, chest pain, palpitations, nausea, vomiting, and sweating. Her medical history includes hypertension and a previous heart attack. Currently, she is taking enalapril, simvastatin, and hydrochlorothiazide. An electrocardiogram (ECG) revealed a regular sinus rhythm with a heart rate of 61 beats per minute. Notably, the ECG showed negative, symmetrical, pointed T waves with an amplitude of 5 mm or greater in leads I, II, aVL, V2, V3, V4, V5, and V6. These findings indicate **subepicardial ischemia** and suggest a potential diagnosis of coronary artery disease.*

![](https://lh7-rt.googleusercontent.com/docsz/AD_4nXcD-kzJGmxQV3Dfc0vXJcOFmfl9_1UVPsRFPc7EuTxXRoknKHvDrOV25S8fa6Zf0N98DaLCr5n6OVFMTil-WuHVkJoexkVsSflehf66eIAYatFeX1ob_m55HyPHBJAkkwSrWK73y5agczgpK1CpISbKn4yM?key=L7rEJxr3LAbZaweCOb8mGA)

- Exemplo 2 | Example #2

Paciente do sexo feminino, 32 anos, com relato de dor torácica. Ao ECG, apresenta bradicardia sinusal com frequência cardíaca de 43 bpm. Percebe-se onda T negativa, simétrica e pontiaguda com amplitude maior ou igual a 5 mm nas derivações V1, V2 e V3. Indica bradicardia sinusal e isquemia subepicárdica, com possível doença arterial coronariana.

*A 32-year-old female patient presenting with chest pain. The ECG shows sinus bradycardia, with a heart rate of 43 bpm. Additionally, there are negative, symmetrical, and pointed T waves with an amplitude greater than or equal to 5 mm in leads V1, V2, and V3. This indicates sinus bradycardia and **subepicardial ischemia**, suggesting the possibility of coronary artery disease.*

![](https://lh7-rt.googleusercontent.com/docsz/AD_4nXdMMR1UlkGNK661G3GM5iVknNN0fhgc2VSrjXKrzk15JZXc-PhpOe0ixBG5h85kcBlft7fGJ74VMf4_NMYYoh5mnJg22BDzBZ2zJS0oj8puDRkv_fcrr2M4UJYKef5bOQF2Wi1LuGPIpsYXsvDm-1ORgcWO?key=L7rEJxr3LAbZaweCOb8mGA)

- Exemplo 3 | Example #3

Paciente do sexo feminino, 88 anos com relato de dispneia e palpitações, em uso de AAS. Ao ECG, apresenta ritmo sinusal regular com frequência cardíaca de 50 bpm. Percebe-se onda T negativa, simétrica e pontiaguda nas derivações V2, V3, V4 e V5. Indica **isquemia subepicárdica** e possível doença arterial coronariana.

*An 88-year-old female patient presenting with dyspnea and palpitations while using aspirin (AAS). The ECG shows a regular sinus rhythm with a heart rate of 50 beats per minute. Additionally, there are negative, symmetrical, and pointed T waves observed in leads V2, V3, V4, and V5. These findings suggest **subepicardial ischemia** and indicate possible coronary artery disease.*

![](https://lh7-rt.googleusercontent.com/docsz/AD_4nXdfttbqDzUngJ_K7i20nZbrPCg9DK9GHjP4I3QADSzjJyz_6OVhX0a76odsrJb_G2ObK_uAumNp3fyjhufClMV-exWov9Dtg-7vr-VcfxRum6oCjar3mKAIICwbI-xHemcesxFGk0Jt2PkSD-Ty0u8e0KVZ?key=L7rEJxr3LAbZaweCOb8mGA)