1 From the Section of Cardiology, Medical Service, FHD, Veterans Administration Hospital, and the Department of Medicine, Medical College of Georgia, Augusta, Georgia.
Correlation between the QRS complex and postmortem ventricular anatomy was made in 1184 instances of normal conduction: (1) Mechanical reliance on the sheer presence or absence of a Q wave greater than 0.03 sec in duration led to "correct" diagnosis of infarction or not in 79% of the series. (2)With normal conduction, abnormal Q waves isolated to either the anteroseptal (Vl-V4) or inferior (II, III, aVF) electrocardiographic zones were frequently false (46%). However, abnormal Q waves restricted to the lateral zone (V5-V6) or in a combination of more than one electrocardiographic zone, were rarely false predictors of the presence of infarction (4%). (3) Classical localization of infarction with normal conduction was statistically relatively reliable as compared with bundle-branch block. The increased frequency of the anatomic pattern of lateral basal infarction in association with normal QRS complexes (but known infarction) suggests relative "electrical silence" of the laterobasal left ventricle in abnormal Q-wave genesis. (4) Lesions confined to a given anatomic location in the left ventricle tended to place particular emphasis and limits on the spectrum of electrocardiographic expression but did not yield a uniform single pattern of Q-wave distribution.
Submitted on November 6, 1970
© 1971 American Heart Association, Inc.
Significance of the Diagnostic Q Wave of Myocardial Infarction
Key Words: Abnormal Q wave • Electrocardiogram • Clinicopathologic correlation • Myocardial scar
Accepted on December 1, 1970
This article has been cited by other articles:
 |
|
 |
|
  G. S. Wagner, P. Macfarlane, H. Wellens, M. Josephson, A. Gorgels, D. M. Mirvis, O. Pahlm, B. Surawicz, P. Kligfield, R. Childers, et al. AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram: Part VI: Acute Ischemia/Infarction A Scientific Statement From the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society Endorsed by the International Society for Computerized Electrocardiology J. Am. Coll. Cardiol., March 17, 2009; 53(11): 1003 - 1011. [Full Text] [PDF]
|
|
|
|
 |
|
 G. S. Wagner, P. Macfarlane, H. Wellens, M. Josephson, A. Gorgels, D. M. Mirvis, O. Pahlm, B. Surawicz, P. Kligfield, R. Childers, et al. AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram: Part VI: Acute Ischemia/Infarction: A Scientific Statement From the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society: Endorsed by the International Society for Computerized Electrocardiology Circulation, March 17, 2009; 119(10): e262 - e270. [Full Text] [PDF]
|
|
|
|
|
|
K. Thygesen, J. S. Alpert, H. D. White, and on behalf of the Joint ESC/ACCF/AHA/WHF Task Force Universal Definition of Myocardial Infarction J. Am. Coll. Cardiol., November 27, 2007; 50(22): 2173 - 2195. [Full Text] [PDF]
|
|
|
|
|
|
K. Thygesen, J. S. Alpert, H. D. White, on behalf of the Joint ESC/ACCF/AHA/WHF Task Force, TASK FORCE MEMBERS: Chairpersons: Kristian Thygese, Biomarker Group: Allan S. Jaffe, Coordinator (USA), ECG Group: Bernard Chaitman, Co-ordinator (USA), P, Imaging Group: Richard Underwood, Coordinator (UK), Intervention Group: Jean-Pierre Bassand, Co-ordina, Clinical Investigation Group: Paul W. Armstrong, C, et al. Universal Definition of Myocardial Infarction Circulation, November 27, 2007; 116(22): 2634 - 2653. [Full Text] [PDF]
|
|
|
|
 |
|
 Task Force Members, K. Thygesen, J. S. Alpert, H. D. White, Biomarker Group, A. S. Jaffe, F. S. Apple, M. Galvani, H. A. Katus, L. K. Newby, et al. Universal definition of myocardial infarction: Kristian Thygesen, Joseph S. Alpert and Harvey D. White on behalf of the Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction Eur. Heart J., October 2, 2007; 28(20): 2525 - 2538. [Full Text] [PDF]
|
|
|
|
 |
|
 N. Herring and D.J. Paterson ECG diagnosis of acute ischaemia and infarction: past, present and future QJM, April 1, 2006; 99(4): 219 - 230. [Full Text] [PDF]
|
|
|
|
 |
|
 S. Fleischmann, P. Koepfli, M. Namdar, C. A. Wyss, R. Jenni, and P. A. Kaufmann Gated 99mTc-Tetrofosmin SPECT for Discriminating Infarct from Artifact in Fixed Myocardial Perfusion Defects J. Nucl. Med., May 1, 2004; 45(5): 754 - 759. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. G. Hundley, T. M. Morgan, C. M. Neagle, C. A. Hamilton, P. Rerkpattanapipat, and K. M. Link Magnetic Resonance Imaging Determination of Cardiac Prognosis Circulation, October 29, 2002; 106(18): 2328 - 2333. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. B. Newman, B. L. Naydeck, K. Sutton-Tyrrell, D. Edmundowicz, D. O'Leary, R. Kronmal, G. L. Burke, and L. H. Kuller Relationship Between Coronary Artery Calcification and Other Measures of Subclinical Cardiovascular Disease in Older Adults Arterioscler Thromb Vasc Biol, October 1, 2002; 22(10): 1674 - 1679. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. G. Shlipak, W. L. Lyons, A. S. Go, T. M. Chou, G. T. Evans, and W. S. Browner Should the Electrocardiogram Be Used to Guide Therapy for Patients With Left Bundle-Branch Block and Suspected Myocardial Infarction? JAMA, February 24, 1999; 281(8): 714 - 719. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. M. Ashton, N. P. Wray, D. Darbar, N. Gillespie, D. T. Mangano, and L. Goldman Preoperative Assessment of Patients with Coronary Disease N. Engl. J. Med., April 18, 1996; 334(16): 1064 - 1065. [Full Text]
|
|
|
|
 |
|
 A. L. GOLDBERGER and M. O'KONSKI Diagnostic Decision: Utility of the Routine Electrocardiogram Before Surgery and on General Hospital Admission * Critical Review and New Guidelines Ann Intern Med, October 1, 1986; 105(4): 552 - 557. [Abstract] [PDF]
|
|
|
|
|
|
S. Kaul, J. B. Newell, D. A. Chesler, G. M. Pohost, R. D. Okada, T. E. Guiney, and C. A. Boucher Value of Computer Analysis of Exercise Thallium Images in the Noninvasive Detection of Coronary Artery Disease JAMA, January 24, 1986; 255(4): 508 - 511. [Abstract] [PDF]
|
|
|
|
 |
|
 B. M. Kennelly, E. Lloyd, and A. G. Rose ECG Recognition of Extent of Acute Myocardial Infarction in Ventricular Extrasystoles Arch Intern Med, July 1, 1980; 140(7): 970 - 971. [Abstract] [PDF]
|
|
|
|
|
|
H. D. Strauss and R. Roberts Plasma MB Creatine Kinase Activity and Other Conventional Enzymes: Comparison in Patients With Chest Pain and Tachyarrhythmias Arch Intern Med, March 1, 1980; 140(3): 336 - 339. [Abstract] [PDF]
|
|
|
|
|
|
H. J. BERGER, A. GOTTSCHALK, and B. L. ZARET Dual Radionuclide Study of Acute Myocardial Infarction: Comparison of Thallium-201 and Technetium-99m Stannous Pyrophosphate Imaging in Man Ann Intern Med, February 1, 1978; 88(2): 145 - 154. [Abstract] [PDF]
|
|
|
|
|
|
J. E. MADIAS and R. GORLIN The Myth of Acute "Mild" Myocardial Infarction Ann Intern Med, March 1, 1977; 86(3): 347 - 352. [Abstract] [PDF]
|
|
|
|
|
|
E. L. Coodley Prognostic Value of Enzymes in Myocardial Infarction JAMA, August 6, 1973; 225(6): 597 - 600. [Abstract] [PDF]
|
|
|
|
|
|
L. Michaels Heparin Administration in Acute Coronary Insufficiency: Its Value in the Initial Stages of Treatment JAMA, September 11, 1972; 221(11): 1235 - 1239. [Abstract] [PDF]
|
|