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ECG done before knee surgery. Should I go for knee surgery?

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Cardiologist
Practicing since : 1981
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ecg results from pre-op for knee surgery (no know heart problems) Do I proceed with the knee surgery or are these ecg results immediately of concern?

heart rate 68
P axis 80
I 40 Axis 85
T 40 Axis 98
QRS Axis 89
ST Axis 67
T Wave Axis 75
EKG Severity ABNORMAL ECG
EKG Impression SINUS RHYTHM
EKG Impression normal P axis, V-rate 50-99
EKG Impression ABNRM R PROG, CONSIDER ASMI OR LEAD PLACEMENT
EKG Impression Q>30mS, diminished R, V2

Posted Thu, 9 Aug 2012 in Bones, Muscles and Joints
 
 
Answered by Dr. Anil Grover 1 hour later
Hi there,
Thanks for writing in.
I am a qualified and certified cardiologist. I read your mail with diligence.
My reasonable guess is:
You are referring to cardiac clearance for a non-vascular surgery. It is not done on the basis of computer interpretation of EKG alone. Anesthesiologist, want to know:
Age & Gender of the person?
Any recent previous major non vascular or vascular surgery?
Any history of heart disease or heart disease or hypertension or diabetes?
Any chronic drugs patient is on and their indication?
Any history of heart failure or ischemic heart disease in past or recent ischemic insult?
On examination overt or covert signs of heart failure?
Report of x-ray by a doctor.
Report of EKG by a doctor.
Any other relevant point from physician's point of view like drug allergy.

These are minimum they want. I will urge you to take no shortcut. Good Luck.T
The values you have written fall within normal limits but nothing more nothing less. I have not seen the EKG nor examined you in person.


With Best Wishes
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by
 
Follow-up: ECG done before knee surgery. Should I go for knee surgery? 1 hour later
EKG Impression ABNRM R PROG, CONSIDER ASMI OR LEAD PLACEMENT
EKG Impression Q>30mS, diminished R, V2

This EKG was read by a doctor, not just the computer. There is no know health issues for this 53 year old female and no previous surgeries or medications. So you are saying that the R progression and Q values are normal? Why did the doctor read this as abnormal? Has she had a silent heart attack, according to this ekg? There is no history of heart disease or hypertension or diabetes.
 
 
Answered by Dr. Anil Grover 28 minutes later
Hi,

EKG says (which you say it is doctor who read it) poor progression of R wave and q wave >30 mili seconds. It also says at least former can be due to faulty lead placement therefore it needs to be repeated. If in absence of diabetes there is no history suggestive of Antero Septal Myocardial Infarction (ASMI). In such situation apart from repeating the EKG, a 2-D echocardiography and normal Treadmill Test will exclude with reasonable confidence any evidence of even silent ASMI. That is why a doctor is necessary to give pre operative clearance.
With Best Wishes. If there is further question I will be happy to answer.

Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by
 
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