Q waves: do they indicate full thickness infarcts?

The link between pathological Q waves and myocardial necrosis was first observed at autopsy in the early 20th century, an observation that has continued to influence ECG interpretation to the present day. As students we are taught that pathological Q waves on an electrocardiogram (ECG) represent permanent, full thickness myocardial necrosis thus implying that the damage is done and subsequent treatment futile: but could advancing technology challenge this widely held perception? With the development of cardiac magnetic resonance imaging (CMRI) and positron emission tomography (PET) the question regarding the significance of Q waves has been asked at a new level.The purpose of this article is to compare theory, pathological observations, CMRI/PET studies and to discuss how myocardial stunning and hibernation are influencing our perception of the Q wave. There are many factors that can influence QRS manifestation which may or may not exhibit Q waves that are permanent or transient, sinister or benign and by oversimplifying the significance of these Q waves many patients could be denied life changing treatment.

Subscribe to get full access to the Journal of Paramedic Practice

Thank you for vising the Journal of Paramedic Practice and reading our archive of expert clinical content. If you would like to read more from the only journal dedicated to those working in emergency care, you can start your subscription today for just £48.

CPD Focus

Reading the Journal of Paramedic Practice counts towards your professional development

Develop your career

We provide professional information dedicated to paramedics covering training, education and jobs

Stay informed

Get the latest clinical information to ensure you are aware of the latest think and best practice in paramedicne

Subscribe now

Already registered? - Sign in here

Keep up to date with Journal of Paramedic Practice!

Sign up to Journal of Paramedic Practice’s regular newsletters and keep up-to-date with the very latest clinical research and CPD we publish each month.