Normal and noninfarct Q waves.
Pseudo-infarct Q waves occur in a number of conditions, related to physiologic or positional variants, altered ventricular conduction, ventricular enlargement, and non-coronary myocardial damage. Prominent Q waves in asymptomatic individuals may be due to previous "silent" myocardial infarction, normal variants, or some pathologic but non-coronary cause. Differential diagnosis may be aided by echocardiography (normal variants, cardiomyopathies, left or right ventricular enlargement, amyloid deposition, and so on). Failure to recognize pseudo-infarct patterns may result in "electrocardiographogenic disease" if the Q wave is a normal variant, or in missing a critical clue to some important pathology such as hypertrophic cardiomyopathy or pulmonary embolism that has very different therapeutic implications from coronary disease.
Goldberger
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Cardiovascular Division, Harvard Medical School, Boston, Massachusetts.
D003937:Diagnosis, Differential; D004562:Electrocardiography; D005189:False Positive Reactions; D006331:Heart Diseases / Q000175:diagnosis; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis*; D011655:Pulmonary Embolism / Q000175:diagnosis