Dear Dori, thank you for your question. A non-Q-wave MI (NQWMI) refers to damage to the
heart muscle that is smaller than with your typical Q-wave MI. MI stands for myocardial
infarction and that's what doctors call heart attacks. In an MI, an atherosclerotic
plaque ruptures in a coronary artery and a blood clot forms there. If the clot completely
occludes the artery, a Q-Wave MI results and damage to the whole heart muscle results because
oxygen and nutrients cannot be delivered to the heart muscle via the coronary artery.
quickly unless that clot is dissolved quickly with powerful clot-busting medications or with
an angioplasty. Heart muscle damage is "through and through" meaning that the entire
thickness of the myocardium is damaged and the live tissue is replaced by scar
tissue. With NQWMI, the clot is usually non-occlusive or is only temporary so some damage to
the heart muscle occurs but it is not "through and through." The way we distinguish these
two types of MI's is by the ECG. With a Q wave MI, changes occur in the ECG that lead
to Q waves developing within 1-2 days. With a NQWMI, changes occur initially in the ECG
but Q waves do not develop. Prognostically, a Q wave MI carries a greater risk of early
death or complications but by 2 years after the event, patients with NQWMI have equivalent
rates of death or adverse events since more late events occur. What that means for
us as cardiologists is that aggressive initial treatment of all patients with chest pain improves
outcomes and saves lives. Thus, we have many different medications and procedures designed
to reopened a clogged coronary artery to save heart muscle. Previously mentioned clot
busting drugs and angioplasty are used acutely for Q wave MI's while intravenous blood
thinners and medications designed to improve coronary blood flow are used for NQWMI's.
I want to leave you with this thought, any MI should be considered a serious
medical problem and prompt medical attention should be sought when chest pain develops. I
hope you find this information useful.
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