Inferior Q-wave on my pre-op EKG

Dr. T Ask Doctor T, Cardiac Risks 2 Comments

Question:

After having a pre-surgery EKG, the surgeon told me I have an inferior Q-wave and wants to refer me to a cardiologist.  I am working on making an appt so I hopefully won’t delay surgery but was very curious and a little concerned in the meanwhile.  I am a non-smoker (quit 14 yrs ago when I became pregnant), non drinker 40 year old woman.  I do not have HTN or DM.  I am obese but am working on it and in the last year lost 50lbs.  The surgeon said the inferior q-wave usually indicates a past MI or current.  Is this true? Could this delay or even forbid my surgery?  If it is of importance, I am having a reaux and Y gastric bypass. Thanks for your time and have a wonderful day.

Answer:

Eveloution-MI-4

While the vast majority of abnormal Q waves are due to myocardial infarction (MI), a significant number are due to other causes. It  depends on how “big” the Q wave is. This is best checked via a cardiology consultation and a stress echocardiogram, and maybe a CTCA Scan.
If you had an MI in the past, you can calculate your risk for heart disease here
http://www.cardiac-risk-assessment.com/app/risk-assessment.php
If no serious heart disease is found and your heart function is OK, it is highly unlikely that your surgery gets canceled. However, a Roux-en-Y gastric Bypass is a big operation, and thus more likely to cause troubles if a person has Coronary Artery Disease (CAD). Therefore it is wise, to get checked out beforehand!
Hope this helps,
Dr T

Comments 2

  1. what sort of other causes would lead to an inferior qwave besides the MI? Upon further review of the EKG, the cardiologist does want me to come in for the stress test. Is it really possible for one to have an MI and not know they had one. I have not had any issues with my heart at all so this has come as a very big suprise to me.

    1. It depends on what your EKG looks like. I cannot judge that from here and it doesn’t make sense to speculate! It is possible to have an MI w/o symptoms, or one caused by an injury to an artery, such as after an accident.
      In your case, based on the results of the 10 year risk analysis, you are at a very low risk. In any case, whether you had an MI before or not, you need an evaluation about your heart function and presence/absence of coronary artery disease. Everything else is speculation and your surgeon needs facts!
      By the way, you are doing so well on diet & exercise, why not continue that and see how far it can get you?
      A gastric bypass has major potential and long term complications and while often very effective, should be reserved for those who are unable/unwilling to do so!
      Hope this helps,
      Dr T

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