Some explanations for a T-wave abnormality on an ECG include myocardial infarction or ischemia, pericarditis, myocarditis, myocardial contusion due to trauma, and mitral valve prolapse, according to ECG Learning Center. The cause for T-wave changes on an ECG is based on the type of abnormality that is present.
Abnormalities in the T wave are classified as peaked, hyperacute, biphasic, flattened, "camel hump" and inverted. Peaked T waves are sometimes seen in patients with hyperkalemia, or a high blood potassium level. Mostly seen in patients experiencing a heart attack, hyperacute T waves appear broad and peaked. They may also be seen in patients with a condition called Prinzmetal's angina. Two main causes of both biphasic and flattened T waves include myocardial ischemia and hypokalemia, or a low blood potassium level.
"Camel hump" T waves may also indicate hypokalemia, and they are sometimes seen in patients with heart block. Inverted T waves may indicate several conditions, including pulmonary embolism, hypertrophic cardiomyopathy and heart attack. Inverted T waves are normal in children, and they sometimes remain inverted into adulthood. Representing ventricular repolarization, T waves are located after the QRS complex on an EKG..