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Done EKG. What is an intra-atrial conduction delay? Mid-precordial repolarization?

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I had an EKG since I need surgery for a torn posterior tendon in the foot.
I'll be having a stress test tomorrow where they'll inject debutelin (misspelled) into me since
I can't do the walking test. They said it will speed up my heart which scares me. First
question is how risky is the test? The other questions relate to the EKG and I have no
idea how serious or not serious it is since I don't understand the terms.
Here are my questions:

What's intra-artial conduction delay?
Minor right and mid-precordial repolarizxation?
Consider feminine pattern?
Small negative T in V2 with flat or low negative T in V3 and V4
Minimal left precordial repolarization disturbance?
Consider lechemia overload or aspecific change
Flat or low negative T in V5 V6?
Borderline EKG?

I just turned 63, am female and take hydrothyocholricide (misspelled) ,a water pill) for prehypetertension

I'm quite concerned about the stress test I have to take as well as this report. I'd very
much appreciate knowing what's going on.

Thank you.
Posted Sat, 15 Sep 2012 in Hypertension and Heart Disease
Answered by Dr. Anil Grover 12 hours later
Hi there,
Thanks for writing in.
I am a qualified and certified cardiologist. I read your question with diligence.
I have copied your questions and each is followed by its answer.

Q: What's intra-artial conduction delay?
A: Cardiac impulse starts from upper chamber of heart and it reaches lower chamber in maximum 200 mille second. Slight delay say up to 240 mille second ought not to cause any problem. However, final call will be taken after stress test and let us see if there is any abnormality there.
Q: Minor right and mid-precordial repolarizxation?
A: I consider that is normal variant like the next one without much significance.
Q: Consider feminine pattern?
A:Ladies are born with some inherent differences in EKG from those of men. Not to worry.
Q: Small negative T in V2 with flat or low negative T in V3 and V4
A: Well, hypertension can cause this. As you are going for surgery doctors wants to be sure this is not coronary artery disease. That is one reason for stress test. With no symptoms your pre test probability of having coronary artery disease is not high. Nonetheless, a stress test looks mandatory to make a categorical statement.
Q: Minimal left precordial repolarization disturbance?
A: Lesser significance than the previous one and because of previous question the ischemic heart disease is being considered but non specific changes which you have mentioned in next question appear more likely. Again I am stressing as you are undergoing surgery no one wants to take a chance that is why stress test is being done. It is very safe non invasive test. Just walk on treadmill and get your every heart beat’s EKG recorded.
Q; Consider lechemia overload or aspecific change
A: For overload exclusion clinical examination was sufficient if it is really being suspected they would do echocardiography. Other part already answered with previous question.

Q: Flat or low negative T in V5 V6?
A: Same as non specific changes or to exclude ischemia that is why stress test is being done.
Q: Borderline EKG?
A: Of course, to be safe it is better to call it borderline EKG and remove doubts by stress test.
Sorry, in your case stress test will not be treadmill test as you have injury to lower limb, therefore as an alternative under strict supervision you will be adminstered DOBUTAMINE injection which has the same effect on your heart as exercise test. It is also non invasive, you do not have do any painful thing and safe. Nothing to worry about the test.

Nothing to worry with jargon. Good Luck.
With Best wishes. You can ask follow up question after stress test, I will be happy to answer.. Again assuring you, stress test is safe non invasive reasonable necessity here. Most likely it will be normal.
Dr Anil Grover
MBBS, MD (Medicine) DM(Cardiology)
Cardiologist and Internist
http:/ WWW.WWWW.WW
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