[Myocardial infarct without pathologic Q waves].

J Lara Terán; A G Hermosillo; A Andrade Freire; A Cuarón Santiesteban; E Salazar

PubMed · 2967060

[Myocardial infarct without pathologic Q waves].

J Lara Terán·A G Hermosillo·A Andrade Freire·A Cuarón Santiesteban·E Salazar

Abstract

Neither the presence nor the absence of pathological Q waves are related to the transmural or subendocardial localization of an acute myocardial infarction. The prognosis of an acute myocardial infarction without pathological Q waves is controversial. We studied 23 hospitalized patients with prolonged, typical chest pain, enzymatic elevation, an EKG without pathological Q waves but with changes in ventricular repolarization and a positive scintigraphy with radioactive pyrophosphates. The patients were classified in two groups according to the pattern of pyrophosphate uptake; group A had grade 2+ focal uptake (N = 13) and group B with grade 2+ diffuse uptake (N = 10). The level of serum glutamic transaminase was significantly greater in group A as compared to group B (p less than 0.05). However, levels of creatine kinase and lactic dehydrogenase were no different. The clinical hospital course was similar in both groups. Eleven patients were followed by 31.7 months: 30.4% had chronic angina, one underwent coronary bypass surgery, another suffered a recurrent myocardial infarction and there were no deaths. The diagnosis of acute myocardial infarction should be suspected in patients with prolonged angor pectoris, electrocardiographic changes in ventricular repolarization, increased enzymatic levels and a positive scintigraphy with a grade 2+ diffuse myocardial uptake of Tc 99m pyrophosphates. The diagnosis is certain if the uptake has a focal distribution.

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Aged Coronary Artery Disease Electrocardiography Female Follow-Up Studies Humans Male Middle Aged Myocardial Infarction Radionuclide Imaging Journal Article

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J Lara Terán, A G Hermosillo, A Andrade Freire, A Cuarón Santiesteban, E Salazar. [Myocardial infarct without pathologic Q waves].. https://pubmed.ncbi.nlm.nih.gov/2967060/

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