Nixon J V
Medical College of Virginia, Richmond 23298.
Postgrad Med. 1994 Apr;95(5):211-4, 216-8, 221-3.
Evidence that non-Q-wave myocardial infarction (MI) is an unstable or incomplete cardiac syndrome is clear. Morphologic findings, coronary pathoanatomy, in-hospital complication rates, risk-stratification data, postdischarge mortality data, and particularly morbidity data indicate a need for close diagnostic evaluation and careful long-term follow-up. Thrombolytic therapy appears to be ineffective in patients with non-Q-wave MI. Measures to prevent reinfarction during the hospital stay are indicated. Any complication of non-Q-wave MI is an indication for cardiac catheterization. All patients with non-Q-wave MI require predischarge risk stratification. If they cannot be stratified by clinical or electrocardiographic characteristics, exercise stress testing is required, preferably with an imaging study. When stratification indicates high risk, predischarge cardiac catheterization is required.
非Q波型心肌梗死（MI）是一种不稳定或不完全的心脏综合征，这一证据是明确的。形态学发现、冠状动脉病理解剖、住院并发症发生率、风险分层数据、出院后死亡率数据，尤其是发病率数据表明需要进行密切的诊断评估和仔细的长期随访。溶栓治疗在非Q波型MI患者中似乎无效。需要采取措施预防住院期间再梗死。非Q波型MI的任何并发症都是进行心脏导管检查的指征。所有非Q波型MI患者都需要在出院前进行风险分层。如果无法根据临床或心电图特征进行分层，则需要进行运动负荷试验，最好进行影像学检查。当分层显示高危时，需要在出院前进行心脏导管检查。
