An electrocardiogram showed Q-waves
that were attributed to her previous MI.
EKG changes are seen in 75% to 95% of affected patients and include the presence of Q-waves
and increased voltages related to LVH.
Variables extracted from surface ECGs, such as abnormal Q-waves
, and intraventricular electrical transients in the SAECG, correlate with myocardial fibrosis and conduction abnormalities (7,8).
HCM patients usually demonstrate a combination of T-wave inversion not including V1, III and aVR, ST-segment depression, left bundle branch block, left axis deviation, pathological Q-waves
, left atrial enlargement and voltage criterion for left ventricular hypertrophy).
Characteristic biphasic T-wave changes in precordial leads without Q-waves
in a pain-free period is called Wellens' syndrome and is associated with severe proximal LAD stenosis.
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The problem is, not all UMIs result in Q-waves
on the electrocardiogram.
Alterations called Q-waves
indicate that a heart attack previously occurred.
The key question when assessing a patient like this is whether the Q-waves
are real or a pseudoinfarct.
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A 2012 cohort study--which included Q-waves
as major criteria and examined fewer minor abnormalities than previous studies--followed 2192 patients 70 to 79 years of age for 8 years.