Absent septal Q waves in otherwise normal electrocardiograms--a variant of normal?

Absence of septal Q waves can be defined as the simultaneous absence of Q waves from all of leads I, V(5), and V(6). This has been considered abnormal by some investigators, but whether this is true of tracings lacking other abnormalities is uncertain. In electrocardiograms (ECGs) from 4,174 patients, 95 were found that were normal except for absence of septal Q waves. Clinical characteristics of these were compared to those of age- and gender-matched patients having normal ECGs with septal Q waves. The ratio of the number of patients with normal ECGs except for absent septal Q waves to the number of patients with entirely normal ECGs was independent of age. Most patients having normal ECGs except for absent septal Q waves had clinically normal hearts, and they were not significantly more likely to have apparent cardiovascular disease than age- and gender-matched controls with septal Q waves. It is concluded that absence of septal Q waves in otherwise normal ECGs may be a variant of normal.