Pathologic Q Waves

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Criteria for a previous myocardial infarction

A pathological is Een pathologische golf (x) is dieper dan 1/3 van de hoogte van het QRS complex (x+y) en breder (d) dan 0,04 sec.
Een pathologische Q golf

Pathologic Q waves are a sign of absence of electrical activity. They can be thought of as an elecrical 'hole'. Myocardial infarction results in scar tissue that is electrically dead and therefore results in pathologic Q waves.

The precise criteria for pathologic Q waves have been debated. Here we present the latest definition as accepted by the ESC and ACC.[1]

Definition of a pathologic Q wave
Any Q wave in leads V1-V3
Q wave > or = to 30ms (0.03s) in leads I, II, aVL, aVF, V4, V4, or V6 (the Q wave changes must be present in any two contiguous lead, and be > or = 1mm in depth).

Note: Absence of pathologic Q waves does not exclude a myocardial infarction!

For those interested: the Minnesota Code Classification System for Electrocardiographic Findings contains a very extensive definition of pathologic Q waves.


  1. Alpert JS, Thygesen K, Antman E, and Bassand JP. Myocardial infarction redefined--a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. J Am Coll Cardiol. 2000 Sep;36(3):959-69. DOI:10.1016/s0735-1097(00)00804-4 | PubMed ID:10987628 | HubMed [Alpert]