Appearance of abnormal Q waves early in the course of acute myocardial infarction: Implications for efficacy of thrombolytic therapy

“Raitt et al. found in a subgroup of 432 first MI patients whose ECG was recorded within the first hour after onset of chest pain that pathologic Q-waves were already present, and this was particularly true for anterior MI patients. These patients had larger final infarct size, but equal benefit from thrombolytic therapy.”

“We've found that often if the delay is longer than three hours and you are able to take the person to the catheterisation laboratory and do angioplasty that is the best thing to do.”

“Whereas it has been argued that baseline Q-waves are 'a poor predictor of symptom duration,' our data support prior observations from fibrinolytic-treated patients contending that they are independent from time from symptom onset and likely represent a more accurate reflection of the wave front of myocardial necrosis.”