What does significant ST-segment elevation in leads with a previous Q wave infarction suggest?

Significant ST-segment elevation in leads that previously displayed Q wave infarction is indicative of a potential ventricular aneurysm. When an area of the heart has sustained damage from a prior myocardial infarction, the cardiac tissue can sometimes become weak and dilated, leading to the formation of a ventricular aneurysm. This is especially relevant if the patient experiences new ST-segment elevation, as it can signify increased strain or wall motion abnormalities in the affected area.

The appearance of ST-segment elevation may suggest acute changes, such as the development of ischemia, or highlight structural changes like an aneurysm. This indicates that further evaluation, often with imaging studies or other diagnostic modalities, may be necessary to assess cardiac function and plan potential interventions.