Not all ST-segment elevation myocardial infarctions become Q-wave myocardial infarctions

D. Luke Glancy, MD, Eleanor J. Daveron, MD, and Suresh P. Jain, MD

From the Section of Cardiology, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA

Supported by an unrestricted educational grant from The Medical Center of Louisiana Foundation.

Corresponding author: D. Luke Glancy, MD, Section of Cardiology, Department of Medicine, Louisiana State University Health Sciences Center, 1542 Tulane Avenue, Room 441, New Orleans, Louisiana 70112.

A 60-year-old man came to the emergency department complaining of a sensation of severe midsternal pressure that persisted for 30 minutes after awakening him. He had first noted chest pressure several weeks earlier, when it would come with exertion and be relieved with rest. Over the previous several days, the discomfort had occurred intermittently at rest. The current episode was by far the longest and most severe, was unaccompanied by other symptoms, and spontaneously disappeared as soon as the patient arrived in the emergency department. The history further revealed good health in the past, 2 to 3 packs of cigarettes per day for 40 years, and no medications. Physical examination findings were unremarkable except for a blood pressure of 180/90 mm Hg. (BUMC Proceedings 2002;15:439-440)