Thread by @akhadilkarMD

One of the most important diagnostic tests in Cardiology to interpret is the EKG.

Here are my thoughts and notes. Will continue to this thread. Let me know what you think!

Thread #12: Q-waves

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Q-wave:
- Can occur in any lead; indicates that the electrical voltages are directed away from that particular lead
- With a transmural infarction, necrosis of heart muscle occurs in a localized area of the ventricle
- New Q-waves usually appear within first day of MI

Anterior Wall MI:
- Can see loss of normal R-wave progression in the chest leads (normally should have a progression of height of R-waves from V1-V6)
- In antero-septal infarct, will lose small r waves in V1-V2 (septal depolarization from left to right) and have QS in V1-V2

Anterior Wall Q-waves:
- Normally V3-V4 have RS or Rs complexes
- If infarction occurs in the anterior wall of LV, there will be a loss of positive R-waves due to the area of muscle that was lost
- Generally results from occlusion of the left anterior descending artery

Antero-septal Q-wave Infarctions:
- Will see abnormal Q-waves in V5-V6
- Infarcts are often caused by occlusion of the left circumflex coronary artery
- Can also have occlusion fo the LAD or branch of a dominant right coronary artery.

Inferior Wall Infarction
- Diaphragmatic portion of the LV, will see changes in leads II, III, and aVF
- May lead to abnormal Q-waves in these leads
- Generally caused by an occlusion in the RCA, less commonly because of a left circumflex coronary obstruction

Thanks for the graphics from this awesome website: litfl.com/q-wave-ecg-lib…

Stay tuned for the next thread on Posterior and RV infarction!