In general, T wave changes are very non-specific. They can occur with hyperventilation, anxiety, drinking hot or cold beverages, and positional changes. Dramatic T wave inversions are often seen in the athletic heart syndrome (a constellation of findings not associated with any pathology), and the dramatic T wave inversions associated with CNS events are very rare. Hyperkalemia (hyperpotassemia) can cause tall, peaked T waves. Hypokalemia and ischemia can cause low amplitude or inverted T waves.