The amplitude of Q-waves may also diminish over time. Moreover, magnetic resonance imaging has suggested that pathological Q-waves may also arise due to extensive subendocardial infarction NSTEMI. If pathological Q-waves occur as a result of myocardial infarction, the infarction may be classified as Q-wave infarction this has negligible clinical implication. Establishing a diagnosis of Q-wave infarction requires that pathological Q-waves be present in at least two anatomically contiguous leads.
In patients with STEMI, ST-segment elevations and pathological Q-waves occur in the same leads, which is why pathological Q-waves can be used to localize the infarct area. Current European ESC guidelines suggest that R-waves may also be used to diagnose previous myocardial infarction.
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Pathologic Q waves are a sign of previous myocardial infarction. They are the result of absence of electrical activity. A myocardial infarction can be thought of as an elecrical 'hole' as scar tissue is electrically dead and therefore results in pathologic Q waves. Pathologic Q waves are not an early sign of myocardial infarction, but generally take several hours to days to develop.
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