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| *[[MI Dagnosis in Paced Rhythm]] | | *[[MI Dagnosis in Paced Rhythm]] |
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| ==Development of the ECG during persistent ischemia==
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| [[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]]
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| [[Image:PathoQ.png|thumb| A [[pathological Q wave|pathological Q wave]]]]
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| 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.
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| 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.
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| {| class="wikitable"
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| |-
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| |+'''Evolution of the ECG during a myocardial infarct'''
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| |-
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| !
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| !see figure
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| !change
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| |-
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| !minutes
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| | not in figure
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| b
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| | hyperacute T waves (peaked T waves)
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| ST-elevation
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| |-
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| !hours
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| | c
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| d
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| | ST-elevation, with terminal negative T wave
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| negative T wave (these can last for months)
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| |-
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| !days
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| | e
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| | [[pathological Q waves]]
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| |-
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| |}
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| {{clr}}
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| ==The location of the infarct== | | ==The location of the infarct== |