title: [Myocardial infarct without Q wave in the elderly: diagnostic evaluation using vectorcardiography].
abstract: The diagnosis of previous non-Q wave myocardial infarction by standard electrocardiographic investigation is uncertain, particularly in elderly patients because of concomitant disease. We have studied 31 elderly patients (aged 63-72 years) with a diagnosis of non-Q wave myocardial infarction between 1-6 months after this acute event. The patients underwent clinical-anamnestic examination, standard electrocardiography, vectorcardiography according to the Frank system and M-mode and 2-D echo-cardiography with continuous and pulsated Doppler. The ECG showed ST-T anomalies in 12 patients (38.7%) whereas the VCG showed anomalies of QRS-loop normal convexity in 27 patients (87%) and 16 of these (51.6%) showed bites criteria (duration > or = 10 msec, voltage > or = 0.1 mV, present at least on two planes). By echocardiography, regional hypo-akinesia was observed in 19 patients (61.3%). Although bites are not only present in myocardial infarction, they indicate an interruption of myocardial gradual electric activation, compatible with fibrous areas, and should be evaluated as a part of the clinical-anamnestic, laboratory and instrumental data.
authors.affiliation: Istituto Medico Chirurgico di Cardiologia, Cattedra di Cardiologia, Seconda Università degli Studi di Napoli.
authors.forename: M A
authors.initials: MA
authors.lastname: Tedesco
authors.forename: G
authors.initials: G
authors.lastname: Ratti
authors.forename: D
authors.initials: D
authors.lastname: Aquino
authors.forename: B
authors.initials: B
authors.lastname: Sarubbi
authors.forename: L
authors.initials: L
authors.lastname: Irace
authors.forename: A
authors.initials: A
authors.lastname: Giasi
authors.forename: G
authors.initials: G
authors.lastname: Cice
authors.forename: P
authors.initials: P
authors.lastname: Coppolino
authors.forename: A
authors.initials: A
authors.lastname: Iacono
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000000981:diagnostic imaging; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000000981:diagnostic imaging; D018617:Ultrasonography, Doppler, Pulsed; D014672:Vectorcardiography
vernacular_title: Infarto miocardico senza onda Q in età geriatrica: valutazione diagnostica con tecnica vettorcardiografica.