Pathological Q waves are more than 1mm wide (40 msec), 2mm tall, more than 1/4 of the QRS height. They are associated with myocardial infarction, old or current.
See also: Q waves
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This ECG is from a man in his 60s who presented with chest pain for 48h with diaphoresis.
This ECG shows inferior ST elevation with reciprocal depression in aVL and I. ST depression in V2-4. Deep Q waves inferior leads and tall R waves V1-3. The cause was a completed infarction with 2 likely culprits (RCA and circumflex).
This ECG is from a man in his 50s who presented with chest pain on a background of known coronary artery disease.
This ECG shows ST elevation with Q waves, high voltage QRS and atypical ST morphology for acute ischemia. On angiography he had three vessel disease but no obvious acute culprit. Serial troponins did not rise and serial ECGs showed no evolution.