Kennedy F B, Ticzon A R, Duffy F C, Raymundo L R, Giacobine J W
J Thorac Cardiovasc Surg. 1977 Oct;74(4):586-93.
Three cases are presented showing the disappearance of electrocardiographic (ECG) evidence of old inferior wall myocardial infarction (MI) after aorta-coronary bypass surgery. Evidence is presented to suggest that the loss of Q waves may be the result of reperfusion of the ischemic myocardium (two cases) and the "cancelling effect" of a new perioperative myocardial damage upon the ECG evidence of an old myocardial infarction (one case). Q waves do not always indicate permanent myocardial scar formation; they are sometimes transient and reversible. Review of the literature provides further experimental and clinical evidences to suggest that surgical reperfusion of peri-infarction ischemic myocardium is an explanation for the ECG change. Pre- and postoperative angiographic and ventriculographic correlations are needed to further clarify the mechanism and clinical significance of such cases.
本文报告了3例患者，其在主动脉冠状动脉搭桥手术后，陈旧性下壁心肌梗死的心电图证据消失。有证据表明，Q波消失可能是缺血心肌再灌注的结果（2例），以及围手术期新的心肌损伤对陈旧性心肌梗死心电图证据的“抵消作用”（1例）。Q波并不总是表明心肌形成永久性瘢痕；它们有时是短暂且可逆的。文献回顾提供了更多实验和临床证据，表明梗死周边缺血心肌的手术再灌注是心电图改变的一种解释。需要术前和术后血管造影及心室造影的相关性研究，以进一步阐明此类病例的机制和临床意义。
