Podcast 630: Evolution of an STEMI

<p><strong>Contributor: Peter Bakes, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Hyperacute T waves can occur immediately and typical last less than an hour</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Hyperacute T waves are typically broader than peaked T-waves, which are associated with hyperkalemia</span></li> </ul> </li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">ST elevation which usually starts within an hour of the inciting event and can last up to a few days, and often follows the hyperacute T-waves</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Q waves can begin at the time ST elevation begins and can remain permanently</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">T waves can invert before normalizing again days later</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-size: 10pt;"><span style= "font-weight: 400;">Levis JT.</span> <a href= "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500486/"><span style="font-weight: 400;"> ECG Diagnosis: Hyperacute T Waves</span></a><span style= "font-weight: 400;">.</span> <em><span style= "font-weight: 400;">Perm J</span></em><span style= "font-weight: 400;">. 2015;19(3):79. doi:10.7812/TPP/14-243</span></span></p> <p><span style="font-size: 10pt;"><span style= "font-weight: 400;">Vogel B, Claessen BE, Arnold SV, Chan D, Cohen DJ, Giannitsis E, Gibson CM, Goto S, Katus HA, Kerneis M, Kimura T, Kunadian V, Pinto DS, Shiomi H, Spertus JA, Steg PG, Mehran R.</span> <a href= "https://pubmed.ncbi.nlm.nih.gov/31171787/"><span style= "font-weight: 400;">ST-segment elevation myocardial infarction.</span></a> <span style="font-weight: 400;">Nat Rev Dis Primers. 2019 Jun 6;5(1):39. doi: 10.1038/s41572-019-0090-3. PMID: 31171787.</span></spa