Vnitr Lek 2006, 52(12):1181-1184

The electrocardiogram in acute myocardial infarction with reperfusion: current concepts regarding Q waves and their dynamics

J. Šochman

Klinika kardiologie IKEM, Praha, přednosta prof. MUDr. Josef Kautzner, CSc., FESC

The formation of Q waves in patients with myocardial infarction with primary ECG - documented ST elevations has been the subject of considerable attention. Less widely known, however, has been the fact that Q waves need not be a permanent feature and may disappear or decrease in quantity in some patients. For some time, the Q wave was perceived as a transmural extent of predominantly non-viable myocardial structures (scars or fibrosis). A most effective method for infarct-related artery recanalization is now available and the latest techniques have demonstrated beyond any doubt that even an invariable Q wave need not necessarily indicate loss of myocardial viability. Even in the era of thrombolysis, successful recanalization of an infarct-related artery led to a specific ECG pattern in patients undergoing artery recanalization or reperfusion of the corresponding myocardial segment. The main features included a decrease in Q waves and, possibly, an increase in R waves in the ECG leads reflecting the respective ischemic events. This overview provides evidence of the significance of the Q wave in the ECG. It therefore comes as a surprise that modern cardiology has given so little attention to the above facts.

Keywords: reperfusion; electrocardiogram; Q waves; myocardial viability

Received: May 11, 2006; Accepted: July 31, 2006; Published: December 1, 2006  Show citation