ECG of Ischemia, MI, and Hypertrophy Flashcards Preview

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Flashcards in ECG of Ischemia, MI, and Hypertrophy Deck (19)
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location of nonSTEMI ischemia

ischemia is usually endocardial


location of STEMI ischemia

ischemia is usually transmural


best method of treatment for STEMIs

opening the blocked artery as soon as possible with angioplasty or thrombolysis


stages of STEMI

hyperacute phase

acute phase

old myocardial infarction


hyperacute phase of STEMI

characterized by the presence of tall, peaked, hyperacute T-waves, with or without ST elevation

occurs minutes after the acute occlusion of the coronary artery and can last up to a few hours

often gone by the time the patient arrives at the emergency department


acute phase STEMI

characterized by elevated ST segments >/= 1 small box

hyperacute T-waves resolve

q-waves may start to appear

can appear within minutes after coronary occlusion but more typically appears in a few hours and lasts up to a few days

after hours or days, T waves begin to invert and ST segments begin returning to baseline


key features of an old MI

Q waves are the hallmark of myocardial scarring typically seen in old and large MIs

duration of Q waves are great than or equal to 0.03 sec or 0.02 sec in V2 or V3

amplitude of Q waves are greater than or equal to 0.1 mV

Q-waves whould be present in 2 contiguous leads



Where is electrical activity in the anterior wall of the LV best seen?

leads V1 - V4


Where is electrical activity in the inferior wall of the LV best seen?

leads I, aVL, V4 - V6


Where is electrical activity in the inferior wall of the LV best seen?

leads II, III, and aVF


ECG findings of nonSTEMI

ST depression, persistent T wave changes, or nothing

diagnosed using enzyme levels in the blood


other causes of ST and T-wave changes other than STEMI

normal variation

ventricular aneurysm



normal variation of ST and T wave

early repolarization of J-point elevation

seen in young people

ST segment electated in multiple leads

St segment usually concave from above


ventricular aneurysm

persistent ST elevation after an MI



St segment is usually elevated in multiple leads

associated with clinical picture

sometimes associated with PR depression

sequential ECG changes differs from those of MI


right atrial enlargement

lead II - amplitude >/= 2.5 mm

lead V1 - amplitude >/= 2.5 mm


left atrial enlargement

lead II - width >/= 3mm

lead V1 - area of negative component >/= 1 mm2


criteria for RV enlargement

in V1, R wave is larger than S wave

in V6, S wave is larger than R wave

in limb leads, right axi deviation

usually, right atrial p-wave abnormality is present


LV enlargement

S wave in V1 + R wave in V5 or V6 >/= 35 mm

R in I + S in III >/= 25 mm

R in aVL >/= 12 mm