Ischemic Heart Disease: This is often the first consideration when seeing T wave inversions on an ECG, as it can indicate myocardial ischemia or infarction. The inversion of T waves can be a sign of decreased blood flow to the heart muscle.

Hypokalemia: Low potassium levels can cause T wave inversion among other ECG changes. It's a common and treatable condition that can lead to cardiac arrhythmias if not addressed.
Hyperventilation Syndrome: This can cause T wave inversion, particularly in the context of anxiety or panic attacks leading to hyperventilation.
Mitral Valve Prolapse: Some patients with mitral valve prolapse may exhibit T wave inversion on their ECG, particularly in leads that correspond to the affected area of the heart.

Pulmonary Embolism: Although less common, T wave inversion in leads V1-V4 can be a sign of a pulmonary embolism, which is a life-threatening condition requiring immediate medical attention.
Cardiac Tamponade: This condition, where fluid accumulates in the sac around the heart, can lead to ECG changes including T wave inversion, and is a medical emergency.
Aortic Dissection: A life-threatening condition where the inner layer of the aorta tears, which can sometimes present with T wave inversion on the ECG, particularly if the dissection involves the coronary arteries.

Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC): A rare heart condition where the muscle in the right ventricle is replaced by fat and scar tissue, which can lead to T wave inversion in the right precordial leads.
Brugada Syndrome: A genetic disorder that can lead to abnormal ECG findings, including T wave inversion in the right precordial leads, and increases the risk of sudden cardiac death.
Myocarditis: Inflammation of the heart muscle, which can cause T wave inversion among other ECG changes, and can be a result of various causes including viral infections.