ECG Changes Over Time in MI 1. Minutes to ~ 30 mins Hyperacute T waves (tall, peaked) Earliest sign of ischemia 2. 30 mins to a few hours ST- segment elevation (STEMI) Indicates transmural ischemia Possible loss of R wave amplitude 3. Hours to 24 hrs Development of pathologic Q waves (wide/ deep) ST elevation may persist T waves begin to invert 4. Days (1-2 days) T wave inversion becomes prominent ST elevation resolves gradually Q waves deepen 5. Weeks to months Persistent Q waves (marker of inf
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