What are the expected ECG changes associated with a history of acute transmural myocardial infarction six months ago?

A history of acute transmural myocardial infarction is characterized by significant alterations in the electrocardiogram (ECG) that reflect the structural and electrical changes in the heart tissue following the event. Deep Q waves are a classic finding on an ECG in patients who have had a myocardial infarction, particularly after a transmural event where the full thickness of the myocardium is affected.

The presence of deep Q waves indicates previous myocardial necrosis or damage; they typically develop over time following the infarction and can persist for many months, often seen six months after the event. These changes occur because the damaged myocardial tissue does not conduct electrical impulses normally, resulting in a characteristic Q wave formation during the depolarization phase of the cardiac cycle.

In this context, while inverted T waves and ST segment elevation may be associated with ongoing ischemia or an acute event, they are not commonly expected six months after an infarction; instead, these changes might resolve or evolve depending on the individual's recovery trajectory. A normal sinus rhythm similarly does not directly indicate myocardial damage from a previous infarction and would not represent the expected changes occurring six months after such an event.

Thus, the expected presence of deep Q waves on the ECG serves as a reliable indicator of a past transm