Pathological Q waves

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.

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ECG Library (46)

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In the ECGquest archives, this ECG has been tagged with: - 12-Lead Anterior ST elevation Pathological Q waves Old vs new ischemia Dr Smith's ECG Blog CC BY-NC
Unusual: Troponin Trajectory to Help Determine Ongoing/Recurrent Infarction vs. Completed Infarction. 31811

This ECG is from a man in his 40s who presented with a cough, shortness of breath and several episodes of chest pressure over the past week or so.

This ECG shows anterior ST elevation and deep QS waves. There was a 100% LAD occlusion that was approximately 2 weeks old.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Syncope 12-Lead Anterior ST elevation Pathological Q waves Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
A man in his 40s with chest pain and syncope after cocaine use 31283

This ECG is from a man in his 40s who presented with chest pain and syncope after cocaine use. He had pain at the time of this ECG.

This ECG shows ST elevation in V1-5 with Q waves anterior and inferior. Brugada-like morphology in V1. The cause was an anterior MI.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Anterior ST depression Inferior ST elevation Pathological Q waves Acute Inferior MI Acute Posterior MI Multi-vessel disease Dr Smith's ECG Blog CC BY-NC
Acute MI, pain onset 24-48 hours ago. Should the patient go for emergent angiogram/PCI? 30678

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).

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Anterior ST elevation Hyperacute T waves Late R wave transition Pathological Q waves Premature ventricular complex Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
What happens when a patient with LAD OMI does not go immediately to the cath lab? 30223

This ECG is from an elderly woman who presented with chest pain.

This ECG shows ST elevation V2-4 with poor R progression and hyperacute T waves. The cause was an acute LAD occlusion.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Inferior ST elevation Pathological Q waves Dr Smith's ECG Blog CC BY-NC
Three EKGs shown to me – which if any need emergent reperfusion? ECG 3 30396

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.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Inferior ST elevation Pathological Q waves Reciprocal ST depression Acute Inferior MI ECG Interpretation CC-BY-NC-SA
ECG Blog #158 (STEMI – OMI – Ischemia – ST depression – not acute) 28883
In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Anterior ST elevation Lateral ST elevation Pathological Q waves Acute Anterior MI Acute Lateral MI Dr Smith's ECG Blog CC BY-NC
Anterior STEMI and multiform PVCs with Narrow Coupling Interval. When to give beta blockers in acute MI? 27649

This ECG is from a middle aged man presented with 45 minutes of chest discomfort on a background of hyperlipidemia. This was his initial ECG.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Anterior ST elevation Pathological Q waves Acute Anterior MI Acute Lateral MI Dr Smith's ECG Blog CC BY-NC
Anterior STEMI and multiform PVCs with Narrow Coupling Interval. When to give beta blockers in acute MI? – repeat 24h later 27860

This ECG is from a middle aged man presented with 45 minutes of chest discomfort on a background of hyperlipidemia. This was his repeat ECG 24h later, after stenting of an LAD occlusion.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Anterior ST elevation Inverted T waves Pathological Q waves Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
Anterior STEMI and multiform PVCs with Narrow Coupling Interval. When to give beta blockers in acute MI? – repeat 48h later 27863

This ECG is from a middle aged man presented with 45 minutes of chest discomfort on a background of hyperlipidemia. This was his repeat ECG 48h later, after stenting of an LAD occlusion.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Anterior ST elevation Lateral ST elevation Pathological Q waves Atrial flutter Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
Tachycardia and ST Elevation – repeat day 2 27635

This ECG is from a middle aged man presented with tachycardia, leg oedema and a raised JVP. This was his repeat ECG the next day after cardioversion and catheterisation.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Inverted T waves Late R wave transition Pathological Q waves Dr Smith's ECG Blog CC BY-NC
See what happens when hyperacute T-waves are missed – ‘baseline’ ECG 27622

This ECG is from a man in his 60s who presented with central chest pain that started while mowing the lawn, associated with diaphoresis, nausea and vomiting, on a background of hypertension and previous infarction. This was his prior ECG on file for comparison.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Pathological Q waves Dr Smith's ECG Blog CC BY-NC
See what happens when hyperacute T-waves are missed – post-intervention 27627

This ECG is from a man in his 60s who presented with central chest pain that started while mowing the lawn, associated with diaphoresis, nausea and vomiting, on a background of hypertension and previous infarction. This was his repeat ECG after intervention.