Early MI and peaked T-waves

Not that I see a lot of acute chest pain in my office—but sometimes, the only EKG sign for early acute MIs are peaked T-waves. If I remember correctly, this is caused by cellular injury resulting in a transient rise of potassium (with is the most abundant intercellular cation). Ischemic and injury patterns such as inverted T-waves and ST changes may take some time to develop. I learned this tip many years ago as a resident when I was evaluating my first patient with an acute MI in the ER.