DISCUSSION part 2

The other possibility is that the right-sided ECG pattern in normal subjects may vary with age. If this is indeed so, then differences can be expected between our study population consisting of young male subjects and the study population of Andersen et al consisting of much older subjects. However, it is interesting to note that in the study reported by Morgera et alconsisting of 82 subjects (45 men and 37 women) without clinical and ECG evidence of cardiac and pulmonary disease and with an age spectrum which is somewhat similar to that of the subjects in the study by Andersen et al (mean, 44 years; range, 17 to 86 years), the prevalence of a combined qS and qr pattern was much lower than that seen in the study of Andersen et al but was similar to that seen in our study.

A knowledge of the actual prevalence and ampli­tudes of the Q waves in the various right-sided chest leads in normal subjects is of more than academic importance. This is so because the presence of deep Q waves together with elevated ST segments in right- sided chest leads, especially in lead V4R, have been found in several studies to be highly sensitive and specific indicators of RV infarction. However, Q waves in right-sided chest leads are a useful clue for RV infarction only if they are infrequently present in normal subjects, which appears to be the case in our study but not in the study of Andersen et al.

In all our 110 subjects, the ST segments blended imperceptibly with the ascending limbs of the T waves and an actual J point could not be identified. Eighty milliseconds after the last QRS complex, the preva­lence of a positive ST deviation of 0.5 to 1 mm was 13 percent in V3R, 5 percent in V4R; and 0 percent in V5R and V6R. No subject showed a positive ST segment deviation of 1 mm.
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T wave inversion was frequently seen in our study. Similar to the experience of Andersen et al,4 the prevalence of a negative T wave in our subjects increased from V3R (60 percent) to V6R (79 percent).

In conclusion, we have described in this study the right-sided ECG pattern in normal male  subjects between the ages of 17 and 22 years. However, since the great majority of right ventricular infarction cases occurs in patients who are about 50 years and older, there is an urgent need for studies of the right-sided ECC pattern in male and female subjects of this age group who have been proven, by other investigations, to be free of pulmonary, coronary artery and other cardiovascular diseases.