Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome on HCM!

Regarding your concern, I would like to explain that QRS-T angle in the frontal plane when studying the limb leads on ECG is the angle between two main axes on vectorcardiography: the mean QRS axis and mean T axis.

An abnormal QRS-T angle means that the angle is widened due to an abnormality of T wave most frequently a flat of inverted T wave in the inferior lead aVF or lateral lead DI.

So to make it simple and clear, in this case the meaning is that T wave abnormalities in the inferior and lateral leads are present.

This evidence may denote a slightly increase cardiac risk (most likely arrhythmic), but no clear conclusions exist in such matter yet.

Similar patterns are shown even in apparently normal individuals, as well as in hypertensive or athletes.

Coming to this point, I would like to explain that when exploring ECG findings, it is important to consider the fact that ECG is only a test helping to conclude on a certain clinical symptomatology.

So ECG findings should not be interpreted separately by the patient's clinical scenario.

In your case it is necessary to further investigate through cardiac imagine and provocative cardiac tests.

The decision to undergo a nuclear cardiac stress test seems rational and will definitely conclude on any implication of cardiac ischemia on the matter.

Nevertheless, I am repeating again that clinical symptomatology is the main issue that should be considering when tailoring the most appropriate diagnostic work up.

Hope to have been helpful to you!

In case of any further uncertainties, feel free to ask me again.

Kind regards,

Dr. Iliri

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Brief Answer:
My opinion as follows:

Detailed Answer:
Dear XXXXXXX

I reviewed carefully your uploaded ECG report. As I explained you above the reason for the abnormal QRS-T angle is due to T-wave abnormalities in the inferior leads.

Also a left posterior fascicular block is present, coupled with a right QRS axis deviation.

As I mentioned you at the beginning of our thread, a cardiac ultrasound and the provocative test (such as a nuclear cardiac stress test) are necessary to further investigate these findings, but it is necessary that these should be done only if a certain clinical symptomatology is present.

Could you please explain if you have had recently any complains?

Let me know about everything!

Regards,

Dr. Iliri

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