Non-Q wave MI

   I am an RN that has worked with cardiology for 8 years. I recently had a MD tell me there was a  difference between a nontransmural MI and a nonQwave MI. I thought they were the same and that a diagnoses was made with a positive CKMB when the ECG findings are nonspecfic for an acute MI.
  Is there a difference and if so what are the ECG criteria for each? Thanks,
  Donna
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Dear Donna,
Thank you for your question.  There is a difference between non-Q wave and non-transmural ischemia.  Q-waves are a pattern of injury after the fact and usually indicate completed infarction and scarring of that portion of the ventricle.  Non-transmural ischemia is seen as ST depression on the ECG.  
In the new era of thrombolytics and cath reprofusion probably better terms are ST elevation and non-ST elevation MI (the "old" non-Q wave MI).  You are correct that the diagnosis of MI is assured with a rise in the MB fraction of CK greater than 12 regardless of the ECG findings.

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