Normally upright in 1, 2, V3-V6
Normally inverted in AVR and V1
Sometimes inverted in III, aVF, aVL, V1
New upright T wave in V1 or T wave taller in V1 than in V6 is pathologic
Inversions in V2-V6 are usually pathologic
Exception is persistent juvenile T-wave pattern, usually limited to V1-V3, classically young Afro-Caribbean women
Greater than 2/3 height of R wave is abnormal
Morphology
Inverted, symmetric,
Transient<unk>  suggests ischemia without infarction
Persistent<unk>  suggests infarction (troponin elevation usually seen)
Pseudonormalization
In presence of baseline TWI (within 1 month), reocclusion causes normalization of TWI
Should be interpreted as evidence of ischemia
Normally inverted in AVR and V1
Sometimes inverted in III, aVF, aVL, V1
New upright T wave in V1 or T wave taller in V1 than in V6 is pathologic
Inversions in V2-V6 are usually pathologic
Exception is persistent juvenile T-wave pattern, usually limited to V1-V3, classically young Afro-Caribbean women
Exception is persistent juvenile T-wave pattern, usually limited to V1-V3, classically young Afro-Caribbean women
Inverted, symmetric,
Transient<unk>  suggests ischemia without infarction
Persistent<unk>  suggests infarction (troponin elevation usually seen)
In presence of baseline TWI (within 1 month), reocclusion causes normalization of TWI
Should be interpreted as evidence of ischemia
Loss of precordial T-wave balance when upright TW in V1 > upright TW in V6
A form of hyperacute T-wave
New Tall T-Wave in V1 (NTTV1) = upright T-wave in V1, especially with proven<unk> from previous ECG
Concerning for ischemia, especially with ACS symptomology
Perform repeat ECGs
Normal variants
Misplaced leads
LBBB
LVH
High left ventricular voltage
Concerning for ischemia, especially with ACS symptomology
Perform repeat ECGs
Misplaced leads
LBBB
LVH
High left ventricular voltage
T wave changes
Normal in pediatrics
ST segment depression
Myocardial infarct 
De Winter's T waves
Myocardial ischemia 
AVR ST elevation
Hypokalemia - T waves go down, then up 