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What Does The Following EKG Reports Indicate?

Posted on Mon, 7 Aug 2017

Question: I was getting pre surgery testing and was told by my doctor that my EKG was abnormal so they had me come in again the next day to the office and I had another EKG and they said it was abnormal again and they thought I may have had a heart attack and want me to see a cardiologist before I get surgery.I have had a couple different doctors look at the EKGs and everyone tells me something different. Please let me know what you think of the EKGs . I have one from January and that one is img1097. The other 2 are from earlier this week. Do any of them look abnormal or changed from the original. If they are changed (as all but one doctor said )what would cause them to be different if I didnt have a heart attack?

Answered by Dr. Dr Sameer Maheshwari (2 hours later)

Brief Answer:
Does not seem to be a Infarct

Detailed Answer:
Hi,
Welcome.
This is Dr Sameer, cardiologist.
Your ECG's are fine & does not show any previous infarction. 12july ECG show RBBB(Right bundle branch block) which can be a normal thing.
Others show poor progression of R wave (which can also be a normal phenomenon) which the ECG machine has wrongly interpreted as Infarction.
I will recommend you to get a 2D Echo done to confirm these findings.
If their would have been any infarction (which is not there as per ECG), it will reflect in the echo.
If echo is also normal, than their is nothing to worry.
Thanks & take care

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr Sameer Maheshwari (34 minutes later)

Is there a reason these things would just show up now? I have been getting a work up for shortness of breath and tachycardia and they diagnosed me with POTS.however none of the many ekgs showed any kind of issues until now. And I had a couple episodes of severe arm pain and chest pain but haven't really had any since. But now my ekg is annormal or changed?

Answered by Dr. Dr Sameer Maheshwari (5 hours later)

Brief Answer:
Detailed answer follows

Detailed Answer:
Hi,
Welcome back.
POTS does not cause any change of ECG. It is just a sinus tachycardia occurring with change of position.
Different ECG's at different time could be most possibly because of positioning of leads for doing ECG. As i said earlier, their is nothing to worry in the current or earlier ECG. But you still should go for echo.
Now as you have a history of chest pain & breathlessness, doing a stress echo will be better for you.
So don't worry and let the results of stress echo come.
It will tell you exactly whether you have any possibility of having a future cardiac event or not.
Thanks & take care

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr Sameer Maheshwari (2 days later)

If I had an echo earlier this year and it was fine, do I really need to get one now that my ekg changed or should it be fine? What causes a right bundle block and what leads do you see it in?

Answered by Dr. Dr Sameer Maheshwari (2 days later)

Brief Answer:
Detailed answer ahead

Detailed Answer:
Hi,
Welcome back.
Sorry for the delayed reply & inconvenience caused.
As i said earlier, ECG does not show any infarct & is normal. Right bundle branch block is a normal finding in many peoples only if their echo is normal. It is actually one of the pulse conducting pathway which is acting slightly less than left. This could be absolutely normal in a normal heart.
I am again telling you to go for a stress echo(and not normal echo) which is a very good test to rule out any current or future possibility of having a heart infarction. If that is normal (which i believe should be normal), than their is nothing to worry about the heart.
I hope this helped your doubts.
Come back if you have any more question.
Thanks & take care

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Above answer was peer-reviewed by : Dr. Kampana