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ECG showed no specific Q wave. Got FBSL and PPBS report. Indication?

DOCTOR OF THE MONTH - Jan 2013
Jan 2013
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Internal Medicine Specialist
Practicing since : 2003
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i had a ecg resently and in the remark coloum it is mentioned:-
NON SPECIFIC Q WAVE NOTED LATERAL/INFERIOR LEADS

what does this mean, do I have a heart problem..????

also my FBSL is 115mg/dl and PPBS is 130mg/dl .....does this mean I have diabetis
my mom has diabetis n my dad had high BP n heart problem n recently passed away after suffering from an Acute Myocardial Infraction
Posted Thu, 30 May 2013 in General Health
 
 
Answered by Dr. Mayank Bhargava 1 hour later
Hi XXXXXX,
Welcome to XXXXXXX forum.

Let me know the associated symptoms along with mentioned.
Do you have chest pain/ squeezing chest sensation/ difficulty in respiration?
Are you an obese or have slim physique?
Are you a smoker or an alcoholic?

With the available described details, it can be concluded that you are suffering from Impaired glucose fasting or prediabetes.
Presence of Q wave in ECG leads generally indicates old infarct.
II, III and aVF are considered as inferior leads.
I, aVL and V1-V6 are considered as anterior leads.

Q wave in III lead has few specification:
1) Q wave in III must be 0.04 sec (full small segment) in duration with associated R wave 5mm and positive P wave.
2) Q wave in aVF must be 0.02 sec (half small segment).
3) a small q or Q wave must be present in II lead.

If all these defined specifications are present then only Q waves are considered as pathological otherwise considered as non-specific in nature.
Non specific Q waves also disappears with deep inspiration.

Blood sugar Fasting must be below 110 mg% and postprandial must be 140 mg%.
Diabetes is diagnosed when fasting blood sugar > 126 mg% and postprandial blood sugar > 200 mg%.
Fasting blood sugar between 110-126 mg% (as you have) is considered as prediabetes or impaired glucose fasting. Postprandial blood sugar between 140-200 is considered as impaired glucose tolerance.

You should consult with XXXXXXX medicine specialist/ cardiologist and should go for thorough check up.
You should also go for complete blood count, serum lipid profile, renal function test, serum electrolytes.
You should also go for 2 D echocardiography, stress test and thallium scan to rule our presence of myocardial infarction in heart (as q wave indicates presence of infarction).

As you have positive family history of diabetes and high blood pressure, yet there appears to be least possibility of heart ailment but you should remain in touch with your treating doctor.

You should perform increased physical activity along with dietary restriction.
You should take low fat diet with avoidance of junk food.

Hope that helps.
Let me know your other query.
Take care,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
 
Follow-up: ECG showed no specific Q wave. Got FBSL and PPBS report. Indication? 49 minutes later
Thankss for d reply doc, I have taken a COMPLETE BLOOD COUNT TEST IN WHICH ALL COUNTS ARE IN LIMITS,
IN THE LIPID PROFILE, TOTAL CHOLESTEROL IS 194, HDL 49, LDL 120 &TRIGLYCERIADES 83 T CHOL HDL/ LDL RATIO IS 4 & HDL/ LDL RATIO IS 2.4 & VLDL CHOLESTEROL (CAL) IS 16.6 MGDL
In the liver function test all is good except SGPT AT 75U/L in the renil profile as well all is good except ALBUMIN IS 4.7 AND GLOBULIN IS 3.7 WITH TOTAL PROTEIIN AT 8.4

I am 24yrs of age and m obese, I dont smoke, I do drink 2 pegs once in 2 days, I weigh 87 kgs n my height is 171 cm
No difficulty in respiration..some times when I take a heavy breaths I do feel some pain in my chestsometimes in the centre or ssometimes on either side of the chest, some times when I bent down to tie my shoe laces I get pain in the lower centre of the chest m not on any medication my bp checked 2 days back was 120/80
After the ecg I had an stress test as well in which the result came negitive for inshemic,
So my question is y is is the stress test is clear y did the ecg show the reading of NON SPECIFIC Q WAVE NOTED LATERAL INFERIOR LEADS

PLS HELP ME M VERY TENSED
 
 
Answered by Dr. Mayank Bhargava 9 hours later
Hi,
As you have only 2 risk factor (positive family history of heart disease and prediabetes), your LDL must be below 130 mg%.
As your LDL is already 120 mg% then there is no need of any statins.
As you have obese physique, there could be possibility of fatty liver disease causing high SGPT.
As stress test is also found to be negative for inducible ischemia, Q wave in ECG is also non specific.
Still you should go for 2 D Echo and thallium scan to rule out regional wall motion abnormality which suggests infarction.
Best regards,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
 
Follow-up: ECG showed no specific Q wave. Got FBSL and PPBS report. Indication? 13 minutes later
thankyou very much doc for your feed back do I need to be worried about the fatty liver
what is thallium scan? and how much would it cost aproximitly??

once again a very big thankyou for yr feed back n precious time to answer my queries

regards, XXXXXXX
 
 
Answered by Dr. Mayank Bhargava 10 hours later
Hi,
Thallium scan is used to differentiate between alive and dead cardiac muscles.
In thallium scan, radioactive thallium is used and injected in blood vessels. Cardiac tissue having well maintained blood supply take up thallium while those area which have poor blood supply lacks thallium.
Cost of thallium scan varies in each & every country and you should consult in regional local hospital.
Sincerely,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
 
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