Transient T-Wave Inversions in a Pregnant Patient: Normal Variant or Cause for Concern?

Pregnancy can cause physiological changes in various body systems, including the cardiovascular system. This manifests as physiological changes in the electrocardiogram (EKG) in the form of sinus tachycardia, a change in the QRS axis, a short PR interval, the development of Q waves, a prolonged QT interval, T-wave inversions, and ST-segment depression. These changes are typically benign and reflect the body's adaptation to pregnancy. Physiological T-wave inversions can occur during pregnancy because of an increased workload on the heart due to expanding blood volume. It is important to identify these physiological EKG changes to avoid unnecessary invasive cardiac work-up and interventions. We present a case of a pregnant female who developed transient T-wave inversions in the EKG without cardiac ischemia.