Pathological Q Waves in a Young Patient Without Ischemic Heart Disease

We present an asymptomatic patient with pathological septal Q waves.

An 18-year-old asymptomatic man was referred for further evaluation after pathological Q waves were identified on an electrocardiogram performed at his own initiative. Electrocardiography demonstrated sinus rhythm with pathological septal Q waves. Physical examination and laboratory tests were unremarkable.

Multimodality cardiac imaging, particularly cardiac magnetic resonance, plays a central role in tissue characterization, differential diagnosis, risk stratification, and therapeutic decision-making in patients with atypical electrocardiographic findings.

Pathological Q waves in young patients often reflect nonischemic heart disease, making advanced cardiac imaging essential to distinguish these findings from myocardial infarction.