Acute Myocardial Infarction.ppt
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Transcript of 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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