Transient Q waves in Prinzmetal's angina

Area of Science:

• Cardiology
• Electrophysiology
• Ischemic Heart Disease

Background:

• Prinzmetal's angina is a form of unstable angina characterized by coronary artery spasm.
• Transient electrocardiographic abnormalities, including ST-segment elevation and T-wave inversion, are common during episodes.
• Abnormal Q waves typically indicate myocardial infarction (heart muscle death).

Purpose of the Study:

• To report two cases of Prinzmetal's angina presenting with transient abnormal Q waves.
• To differentiate these findings from Q waves indicative of myocardial infarction.
• To review literature on transient abnormal Q waves in various clinical settings.

Main Methods:

• Case report of two patients with Prinzmetal's angina.
• Electrocardiographic (ECG) monitoring during symptomatic episodes.
• Review of existing medical literature on transient Q waves.

Main Results:

• Recurrent transient abnormal Q waves were observed during chest pain episodes in both patients.
• These Q waves resolved completely as the chest pain subsided.
• No evidence of myocardial infarction was found in either patient.

Conclusions:

• Transient abnormal Q waves can occur in severe myocardial ischemia due to Prinzmetal's angina without infarction.
• This finding underscores the importance of correlating ECG changes with clinical symptoms.
• Distinguishing ischemic Q waves from infarctional Q waves is crucial for appropriate patient management.