Intermittent noninfarction Q waves: a finding suggestive of latent preexcitation.

Abstract:

OBJECTIVE:To describe 3 patients who presented with chest pain and intermittent Q waves on the electrocardiogram (ECG) and were subsequently found to have latent preexcitation. PATIENTS AND METHODS:During a span of 8 years, 3 patients were evaluated because of atypical chest pain and pathologic Q waves in the inferior leads; in all 3 patients, the Q waves were intermittent. No patient had a history of arrhythmia or had Wolff-Parkinson-White pattern on the ECG. Diagnostic and therapeutic interventions for suspected myocardial infarction included cardiac catheterization in 2 patients, intravenous thrombolytic therapy in 1 patient, and heparin in 2 patients. Ischemic heart disease was excluded in all. Patients underwent pharmacological testing and/or electrophysiologic study for suspected preexcitation. RESULTS:Despite the absence of ECG markers of preexcitation, the presence of a latent accessory atrioventricular connection was confirmed in each patient by pharmacological or electrophysiologic studies. CONCLUSION:In patients who present with intermittent noninfarction Q waves, the most likely diagnosis is latent preexcitation. Clinicians need to be educated about this clinical diagnosis and encouraged to pursue confirmatory testing. Such patients should be informed about the nature and importance of their electrocardiographic abnormality.

journal_name

Mayo Clin Proc

journal_title

Mayo Clinic proceedings

authors

Letts DP,Constantine JC,Littmann L

doi

10.4065/78.7.840

keywords:

subject

Has Abstract

pub_date

2003-07-01 00:00:00

pages

840-3

issue

7

eissn

0025-6196

issn

1942-5546

pii

S0025-6196(11)62684-0

journal_volume

78

pub_type

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