> [!Key Points]
# Hyperacute T waves
- initial T wave tends to be straight (subtle)
- if T wave larger than whole QRS, then obvious hyperacute
![[Pasted image 20230516002219.png]]
![[Pasted image 20230516002310.png| note the morphology with straight portion, not just the height]]
# aVL: T wave inversion / STD
- May be the first marker of an impending inferior wall STEMI
- showing reciprocal changes during development of inferior wall STEMI
- get repeat ECG!
**Normal variants for T inv in aVL:**
- LBBB
- LVH