Pathologic Q waves: Difference between revisions
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==Diagnosis== | |||
[[File:PathoQ.png|thumb|Q wave]] | |||
*Significant if >1 box wide or if is 1/3 of entire QRS amplitude | *Significant if >1 box wide or if is 1/3 of entire QRS amplitude | ||
*Early Repolarization: | *Early Repolarization: | ||
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**Limb leads may also have ST elevation, rarely >2 mm | **Limb leads may also have ST elevation, rarely >2 mm | ||
*Q waves do not always indicate infarction | ===Details=== | ||
*Q waves do not always indicate infarction | |||
*Must distinguish normal septal q waves from pathologic Q waves: | *Must distinguish normal septal q waves from pathologic Q waves: | ||
**Normal septal q wave: <0.04s, low amplitude | **Normal septal q wave: <0.04s, low amplitude | ||
Revision as of 04:20, 25 February 2015
Diagnosis
- Significant if >1 box wide or if is 1/3 of entire QRS amplitude
- Early Repolarization:
- ST Elevation most prominent in lat precord leads (V4-6) but no reciprocal changs
- T waves usually broad, tall (>5mm) & upright
- Limb leads may also have ST elevation, rarely >2 mm
Details
- Q waves do not always indicate infarction
- Must distinguish normal septal q waves from pathologic Q waves:
- Normal septal q wave: <0.04s, low amplitude
- Abnormal septal q wave: >0.04s in I OR in II, III, AND aVF OR V3, V4, V5, AND V6
- Q-wave equivalents in the precordial leads:
- R-wave diminution or poor R-wave progression
- Reverse R-wave progression (R waves increase then decrease in amplitude)
- Must distinguish from lead misplacement
- Tall R waves in V1, V2 (representing "Q waves" from posterior infarction)
Q Wave (Pathologic) DDX
- Ischemic Q waves
- LBBB
- LVH
- Chronic lung disease
- Hypertrophic cardiomyopathy
- Dilated cardiomyopathy