An upright T wave in V1 can be an indicator of Coronary artery disease and a bigger T wave in V1 than V6 suggsts Left Anterior Descending (the widow maker) blood vessel disease.
tsch Med Wochenschr. 2013 Jan;138(1-2):28-30.
Upright T-wave in V1 as predictor of significant coronary artery disease.
Högemann A, Nordmeyer P. abstract here
“in patients with thoracic pain and a positive T-wave in V1 cardiac ischemia should be considered.”