What indicates progressive damage if Q waves develop on an EKG after a STEMI?

The development of Q waves on an EKG following a STEMI (ST-Elevation Myocardial Infarction) is indicative of necrosis of myocardial tissue. Q waves typically represent a loss of electrical activity in the regions of the heart muscle that have died due to sustained ischemia and are a hallmark of infarction that has occurred.

In the context of a STEMI, Q waves signify that the myocardial tissue underneath the area supplied by the affected coronary artery has undergone irreversible damage due to lack of blood flow. This necrosis leads to a loss of viable cardiac muscle, which is directly reflected by the appearance of pathological Q waves in the EKG.

While ongoing ischemia, adverse cardiac remodeling, and improved perfusion may be relevant to the overall condition of the heart post-STEMI, they do not specifically indicate the irreversible damage that is marked by Q wave formation. Ongoing ischemia would refer to continued blood flow deficiency, while adverse remodeling typically occurs as a compensatory response over time. Improved perfusion, on the other hand, would suggest better blood flow to the myocardial tissue, contradicting the idea of Q waves indicating damage. Thus, the presence of Q waves post-STEMI is clearly associated with the necrosis of myocardial tissue