HomeAnswersCardiologyecgI have a non-specific Q-wave in the inferior leads of my ECG report. What does it indicate?

What does a non-specific Q-wave in the inferior leads of the ECG report indicate?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At October 22, 2023
Reviewed AtOctober 22, 2023

Patient's Query

Hello doctor,

What does a non-specific Q-wave in inferior leads of an ECG report indicate? I am attaching the ECG report for better analysis. Kindly suggest.

Hello,

Welcome to icliniq.com.

I have seen your ECG report (attachment removed to protect the patient's identity) and it is normal. There is no pathological Q wave. ECG (electrocardiogram) is always interpreted in the context of clinical history. Please tell me your symptoms and tell me why ECG was done. Do you have previously known cardiac issues?

Thank you.

Patient's Query

Hello doctor,

My father felt chest pain during the day. Based on this he went and got all the tests mentioned. Everything else in the reports was fine. It was just this has been mentioned which I needed to ask. No, there is no known previous cardiac history. Are there any follow-up tests that should be done? Are there any precautions that need to be taken?

Hello,

Welcome back to icliniq.com.

For heart health and prevention of cardiovascular diseases, some general measures are:

  1. Avoid sedentary behaviors.
  2. Do regular moderate-intensity aerobic exercise.
  3. Keep weight low. Abdominal girth should be less than 90 cm for males, and BMI should be less than 23 (for Asians).
  4. After the age of 40 years, yearly blood pressure, blood sugar, three yearly lipid profile, and HbA1c levels should be checked. In case one has hypertension or diabetes, these should be checked early and more frequently.
  5. A healthy diet is important. The DASH diet and Mediterranean diet are the best.

Thank you.

Patient's Query

Hello doctor,

He had some stressful events at work due to which he felt chest pain. Is this important in the diagnosis? Or does the ECG report safely exclude any cardiac event? Thanks for answering the prior query in detail!

Hello,

Welcome back to icliniq.com.

The symptoms, characteristics of pain, and risk factors are important for the interpretation of ECG. Sometimes ECG is very abnormal but the patient is normal, sometimes ECG is very normal but the patient has a major heart attack. Does he have diabetes or hypertension? Does he smoke or drink? All these are risk factors for cardiac disease. How long does the chest pain last? What was the exact location of chest pain was it on the left side of the chest, the center, or the right side? Does he walk? Did he ever feel pain previously in mental or physical stress?

Thank you.

Patient's Query

Hello doctor,

He does not have diabetes or hypertension. He does not smoke or drink. He walks regularly. He has not felt pain before. Pain or thumping in the chest feeling lasted for a few hours. He felt it could be indigestion today but it was just a guess. Can you suggest something based on these facts?

Hello,

Welcome back to icliniq.com.

Good to know he does not have any modifiable risk factor other than age. What I do is keep such patients in observation despite normal ECG. I send a blood test called high sensitivity cardiac troponin I and repeat ECG for few times every 30 minutes. Once this test comes negative and all ECGs are normal then I advise the patient to have a stress test done on follow-up (myocardial perfusion imaging with PET or SPECT scan). You should also have his troponin I test done and at least repeat one ECG.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Muhammad Zohaib Siddiq
Dr. Muhammad Zohaib Siddiq

Cardiology

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