Frequently, people get ECG (electrocardiogram) reports and get confused and concerned by the technical jargon included in the reports (e.g., “Septal infarct age undetermined”). What does it mean? Is this a silently occurring heart attack? Is it a value that shouldn’t cause concern? Is it heart-related? Is there a need to get to the emergency room immediately?
This article explains the facts surrounding the terminology as well as some of the common myths in order to provide the reader knowledge and understanding after clarifying this ECG finding.
What does the report mean?
The words “septal infarct” mean there may be some damage or scarring of the septum (the wall separating the sides of the heart).
The term “age undetermined” states that the ECG machine could not determine when the damage occurred, if it was a recent occurrence, or if it was an old event, or even a real event.
It is important to understand that it is not a diagnosis, and the statement is just an ECG result which is frequently auto-generated. Physicians must thoroughly analyze the situation, and they need to incorporate other diagnostics to draw a conclusion.
Myth vs. Medical Reality
Myth 1: “Septal infarct age undetermined means you definitely had a heart attack.”
Medical Reality:
This is not always true. There are a lot of people with this finding that have never had a heart attack. Automated ECG machines misinterpret various electrical patterns resulting in a false alarm frequently. A lot of studies demonstrate that false positives are very common, especially when electrodes are placed incorrectly.
This phrase should be viewed as a possible indicator, not an actual definitive diagnosis.
Myth 2: “If the ECG shows a septal infarct, it means that there is something very wrong with your heart.”
Medical Reality:
This is sometimes the case, but it could be a technical problem rather than a health problem. Reasons causing errors in readings include:
- Misplaced chest leads (very common in clinics)
- Transient conduction disturbance
- Body composition (obesity, large chest muscles, breast tissue)
- Non damaging small variations
- Differences in the specific machine’s sensitivity
In a lot of these cases, the patient had a perfectly normal heart in the follow up test.
Myth 3: “Age undetermined means the infarct is old.”
Medical Reality:
Age undetermined does not mean old, it means the ECG cannot figure out the age. This could be due to:
- There not being an infarct at all
- It being a normal variant
- It being a false reading
- There being a past conduction abnormality
- Or it being an old silent heart attack, although that is rare
Uncertainty, not timing, is what the term simply reflects
Myth 4: “This ECG finding always needs immediate treatment.”
Medical Reality:
Actual heart damage that requires treatment is confirmed with further testing. What most of the individuals with this ECG line need is:
- A repeat ECG
- Lead placement in the device properly
- A doctor’s assessment
- An echocardiogram, perhaps
If treatment is needed, all follow-up tests will be normal
Myth 5: “Silent heart attacks are extremely common if this message appears.”
Medical Reality:
Silent heart attacks, which are heart attacks that occur with no symptoms, are a thing, but this ECG message does not mean that one has occurred.
Silent heart attacks are confirmed with:
- A cardiologist approved the ECG changes
- Abnormal motion of the wall is shown on an echocardiogram
- Recent blood markers
- Sometimes, a cardiac MRI
Without this, a silent infarct cannot be diagnosed with an automated ECG reading.
Why Do ECG Machines Misinterpret Septal Infarcts?
ECG devices use certain electrical characteristics to detect possible damage. Septal infarcts are detected by looking at leads V1 and V2. There are many harmless conditions that can generate an infarct pattern, including:
1. Incorrect Lead Placement
This is the most frequent cause. If leads V1 and V2 are positioned too high, the ECG may incorrectly indicate a septal infarct.
2. Body Shape Differences
Obesity, muscular build, or breast tissue can modify the electrical impulses to the leads.
3. Normal Variation in ECG Patterns
Some people just have ECG patterns that mimic an infarct, and that is a normal variant.
4. Previous Conduction Issues
Right bundle branch block or left anterior fascicular block can cause unothered results.
5. Machine Sensitivity
ECG machines are not perfect and can be too sensitive in their models. They may “over-interpret” the data to avoid missing an issue.
When is a Septal Infarct Finding More Likely to be Real?
Although it is often the case that few examples will be true positives, the following situations can warrant greater concern:
1. Heart Related Symptoms
- Chest discomfort
- Dyspnea
- Fatigue
- Irregular heart rhythms
2. Risk Factors
- Diabetes
- Hypertension
- Hyperlipidemia
- Tobacco use
- Family history of cardiovascular disease
- Obesity
3. Other Test Results
If there are also other abnormalities uncovered by an echocardiogram or cardiac imaging, the significance of the ECG finding is boosted.
4. History of Silent Myocardial Infarction
Particularly in the case of diabetes, it is possible that a patient may suffer from heart tissue injury without clearly observable symptoms.
What Should You Do If You Are Given An ECG Finding of Septal Infarct, Age Undetermined?
Step 1. Do not be alarmed
This is a common common finding that often holds no real meaning.
Step 2. Have the ECG repeated with proper electrode placement
Results often become normalized.
Step 3. Refer to a cardiologist or your primary care physician
Let a trained human, rather than the computer, read the ECG.
Step 4. If suggested, complete a workup
An echocardiogram that evaluates the structure of the heart and the motion of the walls may be needed; it is the most valuable of tests to rule in or out cardiac disease but rarely needed.
- A cardiac MRI is a very accurate test that may be needed, but is also rarely needed
- A physical or exercise stress test
- Blood tests looking for tissue injury to the heart, typically needed if a recent cardiac event is suspected
Step 5. Manage risk factors
Even if the finding is a false alarm, this is a good opportunity to assess your habits and make improvements to be more heart healthy.
Bottom Line: Facts and Fiction
The reality behind Septal Infarct Age Undetermined may sound alarming, but it is much less dramatic than it sounds. Most of these are misinterpretations and are not heart attacks. Only a clinician can determine whether a finding is meaningful or not. This phrase does septal infarct no value and mostly illustrates the shortcomings of automated ECG readings and no value is offered by automated readings of ECG’s with no evidence of clinical correlation.
FAQs
1. Does Septal Infarct Age Undetermined mean I had a heart attack?
Not at all. This ECG interpretation is very common and, fortunately, it is a misinterpretation of a heart attack.
2. Is this ECG finding dangerous?
Not by itself. Certainly, away from it, this ECG finding should be checked with other clinical tests and the vast majority turn out to be nothing.
3. Can this be a false positive?
Yes. This is a very common phenomenon. It is not unusual to have a false positive ECG because of incorrect placement of leads and other common normal variations.
4. What test most accurately confirms or rules out a septal infarct?
Usually, the most used test to rule out a septal infarct is the echocardiogram. It is true that the cardiac MRI is the most accurate, but it is not indicated most of the time.
5. Should I be worried if I have no symptoms?
It is usually not a cause for concern, but follow up with a doctor.
6. Does “age undetermined” mean the infarct is old?
No. It just means the machine is unable to determine the timing of it, and frequently, it’s not an infarct to begin with.
7. Can lifestyle changes help?
Yes. Regardless of the cause, improving heart health through diet, exercise, and avoiding smoking is always beneficial.
