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February 3, 1993

Q-Wave vs Non—Q-Wave Infarction: An Oversimplified Dichotomy

Author Affiliations

Saint Vincent Hospital Worcester, Mass

JAMA. 1993;269(5):590. doi:10.1001/jama.1993.03500050068023

To the Editor.  —Dr Moss' perceptive Editorial on the "oversimplified dichotomy" between "Q-wave" and "non—Q-wave" myocardial infarction expresses much needed caution about this and related simplifications.1 Moreover, it points up the pernicious influence of flawed terminology, the history of which is instructive in this case. Moss cites the simultaneous publications in 1983 by Phibbs2 and by me,3 pointing out that Q waves were not reliable markers for identifying anatomically transmural lesions and, moreover, that the original literature "establishing" this was seriously misleading on examination of the authors' own data.3My original article was entitled "Q-Wave Infarction vs S-T Infarction," so as to propose to embrace all infarcts (excepting the occasional patient with no significant electrocardiographic change).3 The terms "Q-wave" and "non—Q-wave" infarctions were first coined in a letter by respected cardiologists.4 Unfortunately, this terminology, probably due to its distinguished provenance, was rapidly taken up