what does ST elevation of an ECG of a patient who has recently suffered a heart attack indicate?

Question

was wondering why chlopidogrel and aspirin are contra indicated in MI patients whith elevated ST segment. (According to BNF)

Answer 1

The ST elevation, like any ECG abnormality, is an indication of and alteration to either the electrical activities in cardiac muscle cells and/or the normal progression of electrical signals in the heart, (the heart muscle cells are all electrically connected together, and there are nerves running through the heart - they are called Purkinje fibres).

The sign ST elevation on an ECG is consistent with changes in conduction and cellular activity due to lack of nutrients and oxygen to the cells - therefore it indicates a poor/absent blood supply to a given region of heart muscle (therefore that heart muscle damage is either likely, or is actively occuring)

ST elevation isn't actually the most reliable sign of damage to heart muscle. A better sign is wide and/or deep Q-waves on an ECG. Q-waves can take 24hrs to develop following a myocardial infarction (or "heart attack"), and so, if we were to wait for Q-waves, then it may be a little late to treat a heart attack.

So, actually, heart attacks get divided into NSTEMIs (non ST elevation myocardial infarctions) and STEMIs (ST elevation myocardial infarctions). Provided there are no other contra-indications, STEMIs get treated with thrombolysis or percutaneous coronary angioplasty, as they are more serious than NSTEMIs.

So, in a nutshell, an ST elevation on an ECG, in the presence of clinical signs (such as chest pain, shortness of breath etc..) is a sign that the current heart attack is rather more serious and hence needs riskier/more invasive treatment.

PS: The above pertains to very recent ST elevation, in the presence of clinical signs such as chest pains etc... After a heart attack (assuming the patient survives), the ST elevation gradually settles, but this takes time. So ST elevation in the absence of clinical signs is merely a sign of a recent heart attack and is not, on its own, diagnostic of on-going damage.

Answer 2

I thought elivated T waves were a sign of hyperkalaemia (high potassium levels) Which BNF are you looking at? Mine, no.51, says 'acute coronary syndrome without ST-segment elevation which is not the same as an MI. See NEJM article for more info

Answer 3

Sounds like we're in the same boat...I even asked a specialist after my ECG showed an ST elevation and he mumbled something about blockages in arteries/blood unable to get through the heart valves and all sorts of other medical crap.
I'm still none the wiser to this day.

Answer 4

ST elevation on an EKG can indicate damage to your heart muscle, blocked arteries, etc... But, if the heart is worked on quickly, the muscle can sometimes repair itself..

Answer 5

this clearly shows that the patient has a bad heart problem it could be the mix of drugs also condition could be worsening

Answer 6

They make sure the syringe used to inflict lethal injection for death penalty has to be sterile. Therefore in the same "common sense" I think they would revived him...... lol

Answer 7

thay are still alive