Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
120 Doctors are Online

Having abnormal ECG. Done with ultrasound and ECHO test. Should I go for CT scan? Could supplements replace medicines?

User rating for this question
Very Good
Answered by

Cardiologist
Practicing since : 1998
Answered : 1306 Questions
Question
Please advise if my father is taking corrrect medincines. Can we replace medicines with supplements (Amway)? He got abnormal ECG recently, wherein report mentioned "Right bundle branch block", we got additionally ultrasound and ECHO test done but reports came normal. We were told by doctors to do a CT SCAN, which we did not do and wanted a second opinion.
Posted Tue, 10 Sep 2013 in Hypertension and Heart Disease
 
 
Answered by Dr. Sukhvinder Singh 22 hours later
Brief Answer:
Need more details

Detailed Answer:
Dear Sir
I have gone through all your reports.
1.The ECG shows only "complete right bundle branch block" with normal sinus rhythm with normal PR interval with no significant ST/T/ Q wave changes. This may be a purely electrical phenomenon without any associated heart disease or at times be associated with structural heart disease (especially if patient has symptoms) ]. Next step in such cases is to do an ECHO.
2. The ECHO shows "Akinetic basal inferior wall & basal inferior IVS". Which means that a part of heart has lost its normal pumping action. This usually occurs with severely reduced blood supply or with death of muscle in that part. Please mention if there is any history of heart attack in past. If he has any history of angina on exertion/ undue shortness of breath on exertion? Any relevant history of episode/episodes of chest pain/discomfort? Please also mention what CT scan has been advised by the doctor. Are you talking of CT coronary angiography? please also tell why is he on these 3 medicines?
3. Hemoglobin is high and there is increase in lymphocyte count. Please repeat these tests from a different standard laboratory. Normally hemoglobin is higher in patients of certain lung disorders, smokers and also in some disorders of cells of blood formation. If the results of repeat test are also abnormal, a physician or internist's opinion should be sought.
4. The LDL is 141 mg% and he is on therapy. This seem to be high but I need some more information before I can discuss on this. This includes history of smoking/ history of high blood pressure/ history of heart attack in first degree relative and at what age?
5. TSH is 6.85 mg%. This is marginally high. I would like TSH to be repeated from a different standard laboratory and then proceed according to it's results.
6. Current PSA is normal and he is on treatment for prostatic hyperplasia. He need to follow-up with his urologist only for this.
Please provide the details as I discussed above. Please also narrate all his current symptoms and problems. I will discuss your major concern (about CT scan) after going through the details.
Sincerely
Sukhvinder XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: Having abnormal ECG. Done with ultrasound and ECHO test. Should I go for CT scan? Could supplements replace medicines? 1 hour later
Dear Doctor,
Please find my answers in line with Starting my Name "XXXX– ".
1.The ECG shows only "complete right bundle branch block" with normal sinus rhythm with normal PR interval with no significant ST/T/ Q wave changes. This may be a purely electrical phenomenon without any associated heart disease or at times be associated with structural heart disease (especially if patient has symptoms) ]. Next step in such cases is to do an ECHO.
XXXX– Thanks for explanation.
2. The ECHO shows "Akinetic basal inferior wall & basal inferior IVS". Which means that a part of heart has lost its normal pumping action. This usually occurs with severely reduced blood supply or with death of muscle in that part. Please mention if there is any history of heart attack in past. If he has any history of angina on exertion/ undue shortness of breath on exertion? Any relevant history of episode/episodes of chest pain/discomfort? Please also mention what CT scan has been advised by the doctor. Are you talking of CT coronary angiography? Please also tell why is he on these 3 medicines?
XXXX– My Father doesn't have any history of angina on exertion or else -- only citation could be stairs climbing he feels heavy breath which gets normal after some time. No Chest discomfort/pain reported in past. My father’s father (dada) had reported angina which my father recalls that my dada took Ayurveda medicines. No other family member had reported Angina.
Doctor subscribed CT coronary angiography to be done. When we asked Doctor about timing of CT Corno Angio, they said CT Corno Angio is not priority and can be taken in some time but told to take these 3 medicines, which we started taking from past 1 week.
3. Hemoglobin is high and there is increase in lymphocyte count. Please repeat these tests from a different standard laboratory. Normally hemoglobin is higher in patients of certain lung disorders, smokers and also in some disorders of cells of blood formation. If the results of repeat test are also abnormal, a physician or internist's opinion should be sought.
XXXX– We will try to get the new test done.
4. The LDL is 141 mg% and he is on therapy. This seems to be high but I need some more information before I can discuss on this. This includes history of smoking/ history of high blood pressure/ history of heart attack in first degree relative and at what age?
XXXX– My father and his father’s family doesn’t have past history of HBP and he is complete teetotaler and non-smoker. My father infact sometimes have LBP but as of now BP is normal. My father eldest brother in approx. age of 66 (current age 78) got bypass surgery done, he is doing fine now. One other elder brother died of high BP and heart attack – I am told he used to smoke and drink. One more elder brother got angioplasty done at the age of 65, he is doing fine now.
5. TSH is 6.85 mg%. This is marginally high. I would like TSH to be repeated from a different standard laboratory and then proceed according to it's results.
XXXX– We will try to get the new test done and update.

6. Current PSA is normal and he is on treatment for prostatic hyperplasia. He need to follow-up with his urologist only for this.
Please provide the details as I discussed above. Please also narrate all his current symptoms and problems. I will discuss your major concern (about CT scan) after going through the details.

XXXX– My father is maintaining good health now without any reported concerns. I got my Father full body check-up done and when the ECG report suggested some negative signs, we checked with Cardiologist and asked if this was unusual, we were told to get CT Corno Angio done so we started wondering whether we really need to this expensive test to certify or suggest my father’s state. I am not against getting the CT test done but were afraid if this test was not unnecessary to certify the good health of my Father. I much appreciate your detailed answer and look forward to the guidance you provide.

Regards,
XXXX
 
 
Answered by Dr. Sukhvinder Singh 23 minutes later
Brief Answer:
A repeat ECHO will be helpful.

Detailed Answer:
Dear Mr. XXXXXXX
1. Your father's Target LDL cholesterol level (which is the main target for cholesterol management) is 160 mg% hence it is within permissible limits. However cholesterol lowering drug (rozavel) has been prescribed for the ECHO changes.
2. Your father has been prescribed medicines as well as CT coronary angiogram not for the presence of right bundle branch block (RBBB) in ECG, but for the ECHO abnormality. Since there are no suggestive symptoms and the ECG does not show any evidence of old heart attack, this finding on ECHO is not in sync with other things (although it still may be correct). Sometime this particular region (in RBBB patients) appears less mobile as compared to other areas of heart although it is actually normal (but mostly to new echocardiographers). With these things in mind, I would suggest the ECHO to be repeated by a XXXXXXX Echocardiographer/ cardiologist on priority. If these findings are confirmed again, then next step in such cases is a stress test or a conventional angiogram (but the cardiologist who is actually treating the patient will be the best person to decide on that).
I hope this clarifies the issue. Feel free to write if there is anything else.
Sincerely
Sukhvinder XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: Having abnormal ECG. Done with ultrasound and ECHO test. Should I go for CT scan? Could supplements replace medicines? 7 minutes later
Dear Doctor,
Thanks again for your prompt answer. So, you do not suggest need for getting CT coronary angiogram done correct? but a re-ECHO test done from a XXXXXXX Echocardiographer.

Regards,
XXXX
 
 
Answered by Dr. Sukhvinder Singh 1 hour later
Brief Answer:
please see details below.

Detailed Answer:
Dear Sir
1. The standard approach, as per prevalent guidelines in force, to coronary artery disease (basic medical name of disease causing heart attacks), {which the ECHO report suggests} does not have a role for CT coronary angiography in such circumstances. It is being used increasingly in day-to-day practice but yet to get a nod from "standard organization/bodies" framing guidelines for practice.
2. Since there is mismatch in his symptoms (complaints), ECG findings and the ECHO report, it would be prudent to get a review on priority. Once the findings in ECHO are confirmed, future approach can be decided.
Sincerely
Sukhvinder XXXXXXX
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Medical Procedures

The user accepted the expert's answer

Ask a Cardiologist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor