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June 1990

The Incidence and Prognosis of Unrecognized Myocardial Infarction-Reply

Author Affiliations

Honolulu, Hawaii

Arch Intern Med. 1990;150(6):1350. doi:10.1001/archinte.1990.00390180148039

In Reply.—We appreciate Dr Spodick's comments on our article. We fully agree with the notion that Q-wave infarctions and non—Q-wave (or S-T) infarctions differ clinically, physiologically, and prognostically, but cannot be anatomically differentiated by electrocardiography.1 In our article we used the terms "transmural" (Q-wave) and "subendocardial" (non—Q-wave) infarction simply because many physicians still use these anatomical and electrocardiographic terms indistinctly. We did not intend to equate either the presence of abnormal Q- (or QS-) waves and the anatomical lesion of transmural infarction, or the absence of Q waves and subendocardial infarction.

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