DrVirgo
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In a Transmural MI, which EKG change shows up first?
-Peaked T waves OR ST Elevation?
What is the correct order of EKG changes?
Post MI, which changes remain and which return to normal on EKG?
Edited by DrVirgo on 08/10/07 - 08:39 PM
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| GOGETA
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the chicken came first.
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| GOGETA
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I just could not help me. I do not know I will tell you later.
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| GOGETA
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The Q wave always remain, that is how you know if he had a MI before.
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| kpmle2
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The earliest EKG finding in acute MI is peaked (hyperacute) T waves, followed by ST segment elevation, followed by the inversion of T waves, followed by the appearance of Q waves.
Q wave remains.
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| DrVirgo
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Very Funny GoGeta, I was thinking the same thing when I posted the question. 
yes, you are right: peaked t waves, st elevation, t wave inversion, Q waves.
Ok, according to Kaplan, Q waves could take years - never to disappear.
I was wondering if thats random or are there certain cases or situations in which you know they WILL disappear in years.
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| Drtweetie
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Appearance of new Q waves indicates that irreversible myocardial cell death has occurred, therefore an indication of MI. Q waves usu appear within several hours of onset of infarction, but it could take up to several days to appear in some pts. ST elevation usually has returned to baseline by the time Q waves have appeared. Q waves tend to persist for lifetime of patient. The reason for the Q wave formation is that when an area of myocardium dies, it cant conduct an electrical current, hence all of electrical forces of heart will be directed AWAY from area of infarction. An electrode overlying the infarct will therefore record a deep negative deflection seen as a Q wave.
Hope that helps!
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| cirus
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kpmle2 wrote:
The earliest EKG finding in acute MI is peaked (hyperacute) T waves, followed by ST segment elevation, followed by the inversion of T waves, followed by the appearance of Q waves.
Q wave remains.
Q waves appear before inversion of T wave
Inversion lasts months to years, while Q waves stay forever
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| DrVirgo
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cirus wrote:
Q waves appear before inversion of T wave
Inversion lasts months to years, while Q waves stay forever
according to kap:
peaked t waves -- onset: immed, disapp: 6-24 hours
st elevation -- onset: immed, disapp: 1-6 weeks
t wave inversion,-- onset 6-24 hours disapp: months to years
Q waves. --onset 1-several days. diapp; years to never
I guess Q waves could show up before T-wave inversion since they come on around a day and T-wave inversion comes on around the same time. (?)
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| cirus
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| DrVirgo
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Ok, it's confirmed:
UW also has it in this order:
-Peaked t waves
-ST elevation
-T wave inversion,
-Q waves.
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