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DAVID H. SPODICK, MD, DSc
Worcester, Mass

Arch Intern Med. 1990;150(6):1350.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—Yano and MacLean have marred a very good article¹ on unrecognized myocardial infarction with misleading terminology that has been widely rejected—equating "Q-wave" with transmural infarction.² While most, but not all, Q-wave infarctions probably are transmural, many non—Q-wave infarctions also are transmural. At least since 1983, ^2,3 most medical publications do not accept equating an electrocardiographic pattern with an anatomic pattern as in the past. Terminologic disputes are often quibbles, but not when concepts are involved. Throughout their text the authors equate "Q-wave" parenthetically as "transmural" and "non— Q-wave" as "subendocardial," which is plainly wrong. (The parentheses might sanitize this presentation if they were explained as indicating outmoded usage.)

What we actually see on electrocardiograms is abnormal Q waves or their absence and that is the appropriate mode of reporting. The knowledgeable reader will know that many Q-wave myocardial infarctions may be transmural. The less knowledgeable . . . [Full Text PDF of this Article]

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