Which EKG change is described as consistent with heart failure due to thicker myocardium?

• A. ST elevations
• B. T wave changes
• C. Q waves
• D. U waves

Answer: (B)

When the heart muscle thickens, as in left ventricular hypertrophy, the increased wall stress and relative subendocardial ischemia produce repolarization changes on the ECG. This is often seen as the strain pattern: ST-segment depression with T-wave inversion (flattening or negative T waves) in the lateral leads. These T-wave changes reflect the altered repolarization due to the thickened myocardium, making them the most consistent finding with heart failure from thicker muscle. ST elevations point to acute injury, Q waves to prior infarction, and U waves are linked to electrolyte issues or specific drugs, so they don’t fit as well here.