EKG question

[zacarias, ASN, RN]

Hey all,

I'm not a cardiac nurse (purely medical) although I'd love to be one someday :).

Anyway, my Grandma had a NQMI with pneumonia a few days ago and she's doing OK. She's on tele and probably will go home tomorrow or the next day. She was brought in the morning of 1/9 with Troponin of .3 and then at 8pm her Troponin was 4.5 thus the dx.

It's not a teaching hospital so I never can talk to the doc but he had written NQMI however looking at the EKGs, the top of the EKG (where the computer writes what IT things the problem is) and one of them it says Q-wave and neg T-wave on V4-V6. Well the neg T-wave was there but I didn't see the Q-wave. Of course it could have been a Q-wave with no R-wave, what do I know? Obviously I need to take a serious EKG class to quench my knowledge and get to know this stuff because a Q-wave MI obviously they would have treated more aggressively. Oh well, just wondering if you had any comments. (too bad I can't like attach the EKG as .jpg file for y'all to see hehe)

[gwenith, BSN, RN]

Try this site it has some nice easy explainations of how an EKG works.

http://endeavor.med.nyu.edu/courses/physiology/courseware/ekg_pt1/ekgmenu.html

[mittels]

non Q wave MI is just as important as a Q wave, It just means that on the EKG the Q wave has not dipped in response to her enzymes. Keep and eye on her, did she have CHF as well?

[zacarias, ASN, RN]

Thanks guys.

They do treat NQMI differently, or they can. For instance without ST elevation, thrombolysis will likely not be considered.

Anyway, I'll have to take an EKG class one of these days.

Zach

[Noney]

Did they do a heart cath? If not they need to.

Stres test?

Noney

[Dinith88]

Zacarias,

12-lead EKG class rule #1: The ecg machine can be real stupid. Read the EKG, not it's opinion! Although generally fairly accurate, they can be WAY off.....may well account for why you're not seeing q-waves.

Your "q-wave with no r-wave" statement is confusing??. . If the pattern you're describing looks like a "V" and has no obvious upward deflection from baseline, then there most likely is deep pathologic Q-waves in these leads.

Your grandma probably had several EKG's during her stay. Which one did you see? And has she had heart problems(or any EKG's) in the past? That info would be crucial in reading/interpreting her current EKG.

PS. Glad to hear she's doing well and will be getting out soon!!!Good luck to her!

[zacarias, ASN, RN]

Originally posted by Dinith88

Zacarias,

Your "q-wave with no r-wave" statement is confusing??. . If the pattern you're describing looks like a "V" and has no obvious upward deflection from baseline, then there most likely is deep pathologic Q-waves in these leads.

Dinith,

Thanks for the info. I don't know enough about EKGs to tell whether it was indeed a deep Q wave.

They haven't cathed her and I'm not sure it's indicated. She is 87 with CHF (EF=35% now) and since she's at home now and feeling better, I think she just needs to stay on her CHF meds religiously and she'll be OK MI-wise for the forseeable future.

[HeartnurseSue]

Hi Zach - I am new here and just came across your post. A "non Q wave MI" is simply stated, an MI that that does not injure the full thickness of the wall of the heart muscle. Quite often, a NQMI involves a small vessle, not one of the major blood vessles - having said that tho, it doesn't mean that it couldn't be one of the major vessles. Follow up care and diagnostics is wise advise.

Sue

[carmel]

Try this site it has some nice easy explainations of how an EKG works.

http://endeavor.med.nyu.edu/courses/physiology/courseware/ekg_pt1/ekgmenu.html

i have tried to open the website but couldnt find any info as to ekg cos im interested in the sequence of re-depolarization

carmel