We observed a case where T wave alternans preceded classical ischemic ST segment depression during treadmill stress test. T wave alternans is considered to suggest increased susceptibility to ventricular arrhythmias. Our case suggests that T wave alternans can also be a marker of myocardial ischemia and can precede classical ischemic ST segment depression during treadmill stress test.
Keywords: Electrocardiography,Electrical alternans, Ischemic heart disease, Treadmill test and T wave