Myocardial Infarction: Difference between revisions

Myocardial Infarction (view source)

Revision as of 09:51, 23 July 2007

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→‎The location of the infarct

Drj

Bureaucrats, Administrators

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 The localisation of the occlusion can be adequately visualized using a coronary angiogram (CAG). On the CAG report,  the place of the occlusion is often graded with a number (for example LAD(7)) using the classification of the American Heart Association.<cite>AHACAG</cite>
+==Development of the ECG during persistent ischemia==
+[[Image:AMI_evolutie.png|thumb| The evolution of an infarct on the ECG. ST elevation, Q wave formation, T wave inversion, normalisation with a persistent Q wave]]
+[[Image:PathoQ.png|thumb| A [[pathological Q wave|pathological Q wave]]]]
+The cardiomyocytes in the ''subendocardial'' layers are especcially vulnerable for a decreased perfusion. Subendocardial ischemia manifests as ST depression and is usually reversible. In a myocardial infarction ''transmural ischemia'' develops.
+In the first hours and days after the onset of a myocardial infarction, several changes can be observed on the ECG. First, '''large peaked T waves''' (or ''hyperacute'' T waves), then '''ST elevation''', then'''negative T waves''' and finally '''[[pathological Q waves]]''' develop.
+{| class="wikitable"
+|-
+|+'''Evolution of the ECG during a myocardial infarct'''
+|-
+!
+!see figure
+!change
+|-
+!minutes
+| not in figure
+b
+| hyperacute T waves (peaked T waves)
+ST-elevation
+|-
+!hours
+| c
+d
+| ST-elevation, with terminal negative T wave
+negative T wave (these can last for months)
+|-
+!days
+| e
+| [[pathological Q waves]]
+|-
+|}
+{{clr}}
 ==References==