Goldberger A L
Cardiovascular Division, Harvard Medical School, Boston, Massachusetts.
Cardiol Clin. 1987 Aug;5(3):357-66.
Pseudo-infarct Q waves occur in a number of conditions, related to physiologic or positional variants, altered ventricular conduction, ventricular enlargement, and non-coronary myocardial damage. Prominent Q waves in asymptomatic individuals may be due to previous "silent" myocardial infarction, normal variants, or some pathologic but non-coronary cause. Differential diagnosis may be aided by echocardiography (normal variants, cardiomyopathies, left or right ventricular enlargement, amyloid deposition, and so on). Failure to recognize pseudo-infarct patterns may result in "electrocardiographogenic disease" if the Q wave is a normal variant, or in missing a critical clue to some important pathology such as hypertrophic cardiomyopathy or pulmonary embolism that has very different therapeutic implications from coronary disease.
假性梗死Q波出现在多种情况下，与生理或位置变异、心室传导改变、心室扩大和非冠状动脉心肌损伤有关。无症状个体出现明显Q波可能是由于既往“无症状”心肌梗死、正常变异或某些病理性但非冠状动脉原因。超声心动图（正常变异、心肌病、左或右心室扩大、淀粉样沉积等）有助于鉴别诊断。如果Q波是正常变异，未能识别假性梗死模式可能导致“心电图源性疾病”，或者遗漏一些重要病理情况（如肥厚型心肌病或肺栓塞）的关键线索，而这些病理情况的治疗意义与冠心病截然不同。
