Student...I have a question about EKG's

  1. Hello, all. I'm a nursing student. We've been discussing how EKG's change with MI's and how it can be affected by varying degrees of myocardial ischemia---so, here's my question. After someone has a heart attack and their EKG reflects this (let's say, an ST elevation), will there EKG reflect this elevation for the rest of their life? It seems to me like it should since dead cardiac tissue can't be brought back to life (for now...stem cells FTW). Any explanation is very much appreciated
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  3. by   Georgia SRNA
    So a few thoughts:

    Some of the infarcted area will recover because of collaterals. The necrotic myocardium is cleared, fibrous tissue/collagen is deposited and scarring is complete within about 7 weeks. So the ECG will evolve over this time. If there are inverted T-waves, they may hang around for a few days. ST elevation (with good intervention) usually returns to the isoelectric line within a day or two, sometimes more. As remodeling progresses you also often see the development of a Q wave. This is sort of the classical progression after a STEMI, but it is not always the case. Some people will have some degree of STE for life, some will have inverted t-waves, bundle branch block, etc.

    The quickest resource to answer your question: Sequence of Changes in Myocardial Infarction - Platelet Aggregation - Acute Coronary Syndrome - Cardiology Teaching Package - Practice Learning - Division of Nursing - The University of Nottingham

    Here are two videos (about 40 min total) that are a great look at ECG changes with MIs. Very good place to start and may be all you need.

    1) Intro to EKG Interpretation - Myocardial Infarctions (Part 1 of 2) - YouTube

    2) Intro to EKG Interpretation - Myocardial Infarctions (Part 2 of 2) - YouTube