Myocardial Infarction: Difference between revisions

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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>
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==
==References==