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Stages of an MI

Stages of an MI on ECG and Interventions

QuestionAnswer
What type of injury occurs during the first stage of an MI? Acute Injury
What will you see on the ECG during the first stage? ST Elevations
What period of time does the first stage represent? (What is happening to the heart during this time?) Represents the period of time between the acute blockage of the lumen, and the start of tissue death in the part of the heart that is distal to that plug.
How long does the first/Acute Stage of an MI last? Approximately 6 hours
Where will the ST Elevations occur on the ECG? In ALL of the leads that monitor the affected area of the heart.
What needs to be done during the first stage? Give TPA if not contraindicated for patient.
What type of injury occurs during the second stage of an MI? Necrosis
What will you see on the ECG during the second stage? Big Q Waves (greater than a third of the total size of the QRS.)Maybe flipped T Waves.
Where will you see the Big Q Waves on the ECG during the second stage (necrotic stage) of an MI? In EVERY lead that monitors the affected area of the heart!
If EVERY lead (that monitors an area of the heart) does not show changes r/t an MI, what might be occuring? Artifact, iffy lead placement, anomoly...
Can TPA be administered during the second stage? No
How long does the second stage last? Hours to one day
What is happening if you see ST Elevations and Big Q Waves on the ECG? The patient is transitioning from the first/acute stage to the second/necrotic stage.
What occurs during the third/resolution stage of an MI? Development of scar tissue in the infarcted area.
When does the third/resolution stage of an MI begin? Roughly two weeks after the second/necrotic stage of the MI begins(or one week after it ends.)
What will the ECG show during the third/resolution stage? Persistent Q Waves and maybe flipped T Waves.
How long will the Q Waves and flipped T Waves remain on an ECG? Possibly forever.
What may be happening with a patient who has had persistent flipped T Waves r/t an old MI, but now has upright T Waves? Pseudonormaliztion of T Waves r/t new ischemia.
What interventions need to occur during the first/acute stage? tPA or cath lab (unless contraindicated)
If your patient gets tPA, what changes should you expect to see on the ECG? ST Elevations coming back down to baseline without development of Q Waves
What interventions are needed during the second/necrotic stage of an MI? Too late for tPA. Interventions are directed at the usual stuff: ectopy, changes in rhythm, blood pressure, all that.
Created by: heart2heart