Evolving ST T, QRS abnormalities in acute ST elevation MI, incomplete

Stage
ST-T
QRS
Comment
Duration
Ant
Inf
1
Hyperacute T wave .

• If occur, it is usually in the 1st half hour or less.
• Not commonly seen
May simulating early repolarization, pericarditis, hyperkakemia
• May overlap with early stage 2

•If it occurs, it is of short duration.V4.
1.5
Giant R wave (Tombstone).• If occur, it is usually in the 1st half hour.
• Not commonly seen
• May overlap with early stage 2
•If it occurs, it is of short duration.V4.
2
ST elevation• Begin to develope Q wave• Early stage 2 may overlap with stage 1.
• ST elevation may be concave, straight or convex.
• QT may prolong.
.V3 III
3
Decrease ST elevation
T wave begins inversion
Q wave established During stage 2 and 3, there may be time that ST has returned to baseline but T wave has not inverted. The pseudonormalization.
Persistent ST elevation may suggest wall motion abnormality (LV aneurysm).
.V2
V2
III
4
ST elevation returns to baseline
T wave inversion
QT tends to prolong
.T wave inversion has characteristic of Primary T wave inversion.T wave inversion may persist for days, weeks, months.V3III
5
ST T abnormality returns to normal or baseline. Q wave may resolve in few cases ECG may return to normal or baseline with very rapid reperfusion treatment, (Infarct aborted)...
The magnitude, extent and time course of the ST T change is highly variable
Immediate reperfusion therapy (thrombolysis, primary PCI) may effect the time coarse and magnitude of these changes significantly. (Most of the cases here received immediate reperfusion therapy)

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