ECG CHANGES IN MYOCARDIAL INFARCTION
1. The earliest changes are : tall, positive, hyper acute T waves in the ischemic vascular territory.
2. This is followed by elevation of the ST segments (myocardial "injury pattern").
3. Over hours to days, T-wave inversion frequently develops.
4. And finally, diminished R-wave amplitude or Q waves occur, representing significant myocardial necrosis and replacement by scar tissue.