acute myocardial infarction.ppt

8/18/2019 Acute Myocardial Infarction.ppt

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ST Elevation Mis / STEMI

Non-ST Elevation Mis / NSTEMI


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ST depression, peaked T-waves, then T-wave inversion

The ECG changes seen with a ST elevation infarction are:

Before injury Normal ECG

ST elevation & appearance ofQ-waves

ST segments and T-waves return to

normal, ut Q-waves persist

Ischemia

Infarction

Fibrosis


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A. Normal ECG prior to MI

B. Ischemia from coronary artery occlusionresults in ST epression !not sho"n# anpea$e T-"aves

C. Infarction from on%oin% ischemia results inmar$e ST elevation

&/E. 'n%oin% infarction "ith appearance ofpatholo%ic (-"aves an T-"ave inversion

). )i*rosis !months later# "ith persistent (-"aves+ *ut normal ST se%ment an T-"aves

!ere"s a diagram depicting an evolving infarction:


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There are t"oistinct patternsof ECG chan%eepenin% if theinfarction is,

–ST Elevation (Transmural or Q-wave) or

–!on-ST Elevation (Suben"ocar"ial or non-Q-wave)

Non-ST Elevation

ST Elevation


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Some leas %et a %oovie" of the,

#nterior $ortion

of the heart

%ateral $ortion

of the heart

Inferior $ortion

of the heart


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First, take a lookagain at this pictureof the heart.

#nterior $ortion

of the heart

%ateral $ortion

of the heart

Inferior $ortion

of the heart


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'ne "ay toia%nose an acute

MI is to loo$ forelevation of theST se%ment.


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No" "hat oyou see in the

inferior leas

!ere"s an ECG of an inferior #$ later in time:

ST elevation

Q-waves an"

T-wave

inversion


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ST depression & T-wave inversion

The ECG changes seen with a non-ST elevation infarction are:

Before injury Normal ECG

ST depression & T-wave inversion

ST returns to aseline, ut T-wave

inversion persists

Ischemia

Infarction

Fibrosis


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Note the STepression an

T-"aveinversion inleas -0.

!ere"s an ECG of an evolving non-ST elevation #$:

Question&

'hat area ofthe heart is

infarctin

#nterolateral


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acute myocardial infarction.ppt

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