Significance of the Q wave in acute myocardial infarction

Goldberg, Ronald K.; Fenster, Paul E.

doi:10.1002/clc.4960080106

Cited by 13 publications

(3 citation statements)

References 23 publications

(24 reference statements)

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“…On the other hand, a Q-wave's existence or absence corresponds with several features of a patient's post-MI clinical history and hence has predictive significance. Congestive heart failure is more likely to worsen Q-wave infarctions while they are being treated in the hospital [ 20 ]. Congestive heart failure was more likely to occur later in participants who had their first Q-wave infarction, although coronary insufficiency was more common in participants who had their first non-Q-wave infarction [ 21 ].…”

Section: Reviewmentioning

confidence: 99%

Importance of ECG in the Diagnosis of Acute Pericarditis and Myocardial Infarction: A Review Article

Sarda¹,

Thute²

2022

Cureus

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A promising scientific field is health monitoring and associated technology. A standard testing method to evaluate and identify heart issues is the electrocardiogram (E.C.G.) and diagnose cardiovascular diseases (CVDs). E.C.G. monitoring technologies are becoming more and more prevalent in publications at an exponential rate. E.C.G. is the most crucial tool for screening cardiology and other medical specialities. Twelve leads can be recorded by traditional E.C.G. equipment, while current E.C.G. systems allow for extra leads also with fewer electrodes. Furthermore, "smart" gadgets allow patients to take an E.C.G. at residence. Presenting different ischemia-related symptoms on the E.C.G. by the most recent recommendations. Presentation of contemporary E.C.G. systems and their possible benefit in identifying ischemia-related E.C.G. symptoms based on recent study findings. The identification of ischemia E.C.G. abnormalities can be facilitated and optimised by current E.C.G. systems using vector-based electrocardiography. Although they can be effective for documenting transient E.C.G. abnormalities, especially inside the S.T. segment, smart non-vector-based devices for patients are primarily beneficial for the diagnosis of arrhythmias and cannot substitute the 12-lead E.C.G. for the diagnosis of ischemia. The electrocardiogram (E.C.G.) is inexpensive and easily accessible, but because of its alleged limited specificity, its utility as a screening tool for early detection of athletes with a cardiac condition in danger of immediate cardiac death is contentious. The interpreting parameters have been continuously evolving over the past 10 years as various efforts have been made to better the separation between healthy and pathological E.C.G. abnormalities in athletes. Electrocardiographic abnormalities that are unrelated to cardiac electrical activity are known as electrocardiographic artefacts. E.C.G. elements, including the baseline and waves, can become altered as a result of artefacts.

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Section: Reviewmentioning

confidence: 99%

Importance of ECG in the Diagnosis of Acute Pericarditis and Myocardial Infarction: A Review Article

Sarda¹,

Thute²

2022

Cureus

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“…It has been indicated that Q-wave infarction is associated with higher levels of certain enzymes including serum glutamicoxaloacetic transaminase (SGOT), lactate dehydrogenase (LDH), and creatinine phosphokinase. These high enzyme levels are caused by the presence of considerable myocardial necrosis presence [4][5][6].…”

Section: Myocardial Infarctionmentioning

confidence: 99%

The Significance of Troponin and Ck-Mb in Association with Q-Wave Myocardial Infarction

Harahap

Margata

2018

idjpcr

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Abstract. Acute myocardial infarction (AMI) is the global main cause of morbidity and mortality. AMI describes the process of cell death due to prolonged ischemia identified by the appearance of pathological Q-wave in electrocardiogram (ECG). Myocardial cell death does not occur directly after the onset of myocardial ischemia, however, it occurs more than 6 hours after the onset. Thus, certain cardiac markers, such as cardiac troponin and creatinine kinase-MB (CK-MB) which formed in myocardial cell damage, play a vital role in diagnosing AMI. Keywords: Cardiac Biomarker, CK-MB, Diagnosis, Q-wave Myocardial Infarction, Troponin

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“…Finally, table II summarizes the mean peak CK data for all 544 patients with isoenzyme-confirmed acute non-Q wave MI. In spite of the fact that 48% of the study cohort had 'combination location' non-Q wave infarcts, their peak Other investigators have lobbied passionately for abandonment of the terms 'transmural' and 'nontransmural' in favor of Q wave and non-Q wave MI [2, 3,[27][28][29], Still others have advocated the adoption of a terminology which comprises 'Q wave MF, 'S-T MF and 'T wave MF [3,30,31], Indeed, Spodick [3] has elo quently emphasized the nonspecificity of ECG criteria for differentiating transmural and nontransmural le sions, pointing out that despite the clinical, physiologic and prognostic differences between the two infarct sub-CK values were not significantly different from the sub groups whose non-Q wave MI was localized to a single lead group.Thus, the early ECG findings in non-Q wave MI were most frequently 'global' (i.e. multiple lead group loca tions), were less commonly isolated to a single ECG loca tion and were nonlocalizable in almost 20% of patients.…”

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confidence: 99%

Electrocardiographic and Enzymatic Findings in Acute Non-Q Wave Myocardial Infarction

Boden¹,

Kleiger²,

Gibson³

et al. 1988

Am J Noninvas Cardiol

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In spite of the apparent rising prevalence of non-Q wave myocardial infarction (MI), and the widespread applicability of cardiac enzymes in the diagnosis of myocardial necrosis, all prior published studies have required obligatory ST segment shifts and/or T wave inversions in the diagnosis of non-Q wave MI. Accordingly, the frequency of clinically and enzymatically defined non-Q wave MI without indicative electrocardiogram (ECG) changes has never been assessed, nor has a systematic analysis of serial ECGs and cardiac enzymes been undertaken in a large prospective non-Q wave MI population. We utilized the extensive data base created from the Diltiazem Reinfarction Study of MB-creatine kinase (CK)- confirmed non-Q wave MI, which was a multicenter study of the effect of diltiazem therapy on early reinfarction. Five hundred and seventy-six patients underwent serial ECG analyses on admission, study day 2, study day 3 and at predischarge (10 ± 2 days after trial entry). A total of 2,304 ECGs were analyzed by 5 blinded investigators, and tracings were examined for the presence or absence of definable ST-T wave changes in 2 or more leads within 3 ECG lead groups: anterior = V(1) - V(4); inferior = II, III, aVF; lateral = I, aVL, V(5) - V(6); combination location = 2 or more lead groups; nonlocalizable = no diagnostic ST or T wave abnormalities. CK and MB-CK values were measured at 12-hour intervals throughout the 14-day study period. At study entry, 32 patients (5.5 %) were found, in retrospect, to have had acute Q wave MI at entry, 439 of the remaining 544 patients (81 %) had localizable ECG changes and 105 (19%) did not. Combination location (≥2 lead groups) non-Q wave MI was the most prevalent (48%), followed by lateral location (18%), anterior location (14%) and inferior location (8%). ST segment elevation was noted in 187/544 patients (34%) on the admission ECG, but in only 37 patients (20%) did Q waves develop subsequently. Of note, mean peak CK values were not significantly different among subgroups, and the highest mean CK values were observed in patients with nonlocalizable non-Q wave MI (668 ± 877 vs. 616 ± 26 IU for the remaining localizable subgroups; p = NS). We noted further that 76 of 544 patients (14%) progressed to Q wave MI during the 14-day observation period, and 67 patients (12%) ‘normalized’ their ECGs prior to discharge. Thus, the early ECG findings of non-Q wave MI are most frequently global, less commonly isolated to a single ECG lead group, are attended by a high prevalence of initial ST segment elevation, and are nonlocalizable in almost 20% of patients.

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Significance of the Q wave in acute myocardial infarction

Cited by 13 publications

References 23 publications

Importance of ECG in the Diagnosis of Acute Pericarditis and Myocardial Infarction: A Review Article

Importance of ECG in the Diagnosis of Acute Pericarditis and Myocardial Infarction: A Review Article

The Significance of Troponin and Ck-Mb in Association with Q-Wave Myocardial Infarction

Electrocardiographic and Enzymatic Findings in Acute Non-Q Wave Myocardial Infarction

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