Abstract
The appearance time of abnormal Q waves in standard 12 leads ECG may differ individually in acute myocardial infarction. We noticed its appearance time and devided 107 cases with acute transmural infarction, who were admitted within four hours of the onset of attack, into an early appearance group (group E: less than four hours after the onset of anterior infarction and less than seven hours after inferior infarction) and a late appearance group (group L: four hours or more after anterior infarction and seven hours or more after inferior infarction) . The incidence of prior angina pectoris persisted for one month or longer showed a significant higher rate in group L. Of the types showing an unstable angina, the rate of changing patterns were significantly higher in group L. The degree of chest pain tended to be severe in group E. The maximal degree of ST elevations in 12 leads was significantly higher in group E. Cases with multiple coronary vessel disease showed a high rate in group L. The peak GOT and CK were significantly low in group L. For the hemodynamic findings on admission, CI and SWI in group L were significantly high and PCWP showed a low level. The complication of VT, VF and Af, AF, PSVT were highly seen in group E. In conclusion, the development of myocardial defense mechanism such as the formation of collateral circulation was suspected a one of participating factor in delays with abnormal Q waves appear, and the evolution process of abnormal Q waves was considered a useful indicator reflecting the infarction clinical state.
