ECG changes associated with pediatric myocardial infarction:
(1) wide Q waves (> 35 msec), either new or occurring in an existing Q waves
(2) increased amplitude of existing Q waves
(3) new-onset Q waves in serial tracings
(4) Q wave notching (any abrupt change in the smooth contour of the Q wave)
(5) ST segment elevation > 2 mm when associated with any of the Q wave abnormalities listed above
(6) prolonged QTc (> 440 msec) when associated with any of the Q wave abnormalities listed above
where:
• A wide Q wave is associated with a transmural myocardial infarction.
• Q wave notching may be a poor prognostic finding.
Other changes seen with myocardial injury:
(1) deep Q waves if the patient has known or suspected Kawasaki’s disease
