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Having blood pressure and high cholesterol. Started chest pain. ECG done. Should I be concerned?

Jan 2013
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Internal Medicine Specialist
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Asian male, DOB SEP 27 1954. 5'10", 185 pound, normal health, blood pressure 120/84. high cholesterol (220-280 range in the last 10 years), not taking any medication. 2 weeks ago started to have occasional chest pain. Currently traveling outside USA, went to a local doctor yesterday, took ECG. Want second opinion. Below is the EKG result (full graph in pdf file, available for email or uploading)
Hear rate 81bpm
PR 156ms
QRS 112ms
QT/QTc 372/410 ms
P/QRS/T axle 46/71/38 degree
RV5/SV1 1.05/0.83 mV
RV5+SV1 1.88 mV

Should I be concerned? Any medication suggestion?
Posted Tue, 24 Jul 2012 in Hypertension and Heart Disease
Answered by Dr. Mayank Bhargava 41 minutes later

Thanks for posting your query.

1) Your heart rate is also normal. Heart rate between 6-100/BPM is normal. > 100/ BPM is called as Tachycardia. <60/BPM is called as Bradycardia.

2) Your PR interval is normal (120-200ms). Long PR interval is >200ms.

3) Your QT interval is normal. Short QT interval is ≤300ms.

4) Your QTc interval is also normal. An "abnormal" QTc in males is a QTc above 450 ms, and in females, above 470 ms.

5) Your P wave axis is normal (0˚ to +75˚).

6) Your QRS wave axis is also normal (+90˚ to -30˚).

7) R wave in V5/ V6 must be <2.6 mv in normal ECG, more than this will be counted as hypertrophy. Your parameter is also normal.

8) R V5+ S V1 must be <3.5 mv in normal ECG, more than this will be counted as hypertrophy.Your parameter is also normal.

9) So your ECG appears to be normal.

10) As you are suffering from deranged lipid disorder, you should consult with physician/ cardiologist as you are at high risk of heart disease.

Hope this will solve your query.

Best regards,

Dr. Mayank Bhargava
Above answer was peer-reviewed by
Follow-up: Having blood pressure and high cholesterol. Started chest pain. ECG done. Should I be concerned? 22 minutes later
what is "deranged lipid disorder", can you give me a brief explanation in plain language? Thanks.
Answered by Dr. Mayank Bhargava 9 hours later

1) Deranged Lipid Profile means disturbed range of your cholesterol, LDL, VLDL, HDL

2) Total cholesterol should be < 200mg/dl

3) HDL should be ≥ 60 mg/dl

4) Triglycerides should be < 150 mg/dl

5) Treatment of lipid disorders are decided by LDL level:

Therapy of dyslipidaemia depends on your risk factor .

You can go for ATP Panel III guidelines on internet .

For your knowledge i am giving you little bit

Risk factors include
1) cigarette smoking
2) hypertension (bp 140/90 mmhg or on antihypertensive medication)
3) low hdl cholesterola [
4) diabetes mellitus
5) family history of premature chd
Chd in male first-degree relative
Chd in female first-degree relative
6) age (men 45 years; women 55 years)
7) lifestyle risk factors
Obesity (bmi 30 kg/m2)
Physical inactivity
Atherogenic diet
8) emerging risk factors
Prothrombotic factors
Proinflammatory factors
Impaired fasting glucose
Subclinical atherogenesis

If you have one risk factor then therapy is indiacted when ldl >190

If 2 risk factor and 10 years risk is 10-20% then therapy is indicated ldl>160

If 2 risk factor and 10 years risk is >20% then therapy is indicated ldl>130

If you have positive family history of heart disease & dm then ldl should be 100

But for a diabetic patient its better to keep ldl at 70

You can calculate your risk factor and can decide your therapy

Hope this will solve your query,

Dr. Mayank Bhargava
Above answer was peer-reviewed by
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