Acute Q-wave versus non Q-wave myocardial infarction: clinical and regional wall motion abnormality studies

ABSTRACT

Clinical spectrum and echocardiography studies were performed on 30 patients divided into two groups. Group I [QMI group] included 16 patients and group II [NQMI group] included 14 patients. Early echocardiography was done 24 hours after infarction and another one was done after 2 weeks. There was no difference between both groups as regards clinical data. There was a highly significant increased duration of symptoms before infarction [P <0.01] and a significantly increased number of ischemic episodes after infarction [P <0.05] in the NQMI group than QMI group. There was a highly significant increased CPK-MB enzyme in the QMI group than NQMI group [P <0.01]. There was no statistically significant difference between both groups as regards the segmental wall motion abnormalities early after myocardial infarction, but after 2 weeks there was a highly significant decreased wall motion score in the NQMI than the QMI groups [P <0.01]. There was a significant decrease in wall motion score [WMS] between early and late echocardiography [P <0.05] in the NQMI group, but there was a nonsignificant difference between the two echocardiograms WMS in the QMI group. So, the present study suggested that NQMI is more unstable than the QMI in the clinical course. Improvement in regional wall motion suggested increased risk of future ischemic events in the NQMI group. Serial echocardiographic imaging may be used to identify patients at risk for infarct extension in both QMI and NQMI patients