Prodromal chest pains: clues to the pathogenesis of non-Q wave acute myocardial infarction?

Prodromal chest pains were recorded from consecutive admissions to a single coronary care unit and the symptoms of those with Q wave and non-Q wave acute myocardial infarction were compared. Of 809 admissions there were 201 with Q wave ad 88 with non-Q wave infarction. The non-Q wave infarction group was older, included more women and a greater proportion had suffered a previous myocardial infarct. Effort angina was equally common in both groups, but in the Q wave infarction group, angina was more often of recent onset, within the previous 4 weeks. Symptoms to indicate worsening angina, more prolonged, intense or frequent pain, were equally common in both groups. These findings suggest that although the extent of coronary artery disease may differ, Q wave and non-Q wave myocardial infarction share a common pathogenic mechanism.