Transient Abnormal Q Waves in the Course of Ischemic Heart Disease

¹ Service de Cardiologie et Urgeneces Circulatoires, Hôpital Tenon, Paris, France

The significance of transient abnoraml Q waves (TAQW) observed during acute coronary insufficiency was studied in 15 patients with atherosclerotic heart disease. TAQW occurred during anginal chest pain (10 of 15), cardiogenic shock (3 of 15) and paroxysmal dyspnea (2 of 15). The anterior myocardial wall was more frequently involved (13 of 15) than the diaphragmatic wall (2 to 15). Serum enzme levels were normalor slightly increased in 11 of 15. TAQW disappeared in four hour to nine days (mean three days). Three patients died and an autopsy was performed on two of them. It is conclude that cases with TAQW include: (1) acute episodes of myocardial ischemia, without myocardial infarction (MI) (8 to 15); (2) MI with early electrical recovery due to predominant ischemia (4 to 15); and (3) exteriorization of previous MI patterns (3 to 15). Abnormal Q waves which disappear in the MI course, reappear transiently during an acute ischemic episode. It is emphasized that electrical inertia as not synonymous with irreversible myocardial damage.