Brief Answer:
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Detailed Answer:
Dear Sir
1. The ECG shows Sinus rhythm with prolonged PR interval with Left anterior hemiblock with Non-specific interventricular conduction delay. The findings may result from intrinsic disease of conduction system of heart/ certain medication/ structural heart disease or at times can be a normal variant.
2. If you ever had blackout/ transient loss of consciousness/ unexplained fall, then these finding may be important and you need to see your cardiologist. If none of these have taken place ever, we normally get a cardiac ultrasound or ECHO done in such scenarios. If that also comes to be normal, there is nothing to be done either for these ECG findings or for PVCs.
Hope this helps. Feel free to discuss further.
Sincerely
Sukhvinder

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Brief Answer:
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Detailed Answer:
Dear Sir
1. Prolonged PR interval means that the duration between onset of P wave to that of QRS complex is more than normal. This usually happens due to delay in conduction through AV node. Non-technically, The electrical activation of pumping chamber of your heart (ventricle) occurs after a time delay following activation of receiving chamber of your heart (atria). If this delay exceeds a certain time interval , it is called prolonged PR interval or first degree AV block. This has a number of reasons and is usually benign.
2. Non-specific interventricular conduction delay means that ECG shows that total time in activating your ventricles is more than normal but it does not pertain to one of the two specific well defined patterns of delay; namely those two patterns are RBBB and LBBB. Again this may be a normal variant or associated with structural heart disease or disease of conduction system of heart.
3. Left anterior hemiblock- in our conduction system, ventricles are supplied by a number of "electric wires" like nerves. Right ventricle by right bundle and left ventricle by left bundle. Left bundle divides further into two fascicles anterior and posterior. Your ECG shows a conduction defect in let anterior fascicle. More often than not it is benign entity.
4. The heart can not be judged like this (scale of 1-10) on the basis of ECG. ECG only provides indicators towards disease. Uncommonly, it provides the exact diagnosis. I have already explained the clinical relevance of these findings in my first answer. If you did not have any symptoms as yet and your heart is normal on cardiac ultrasound, there is nothing more to be done in this regard. However if you had symptoms or your cardiac ultrasound is not normal, you must consult your cardiologist.
5. Since the ECG points to defects of conduction system, there is theoretical risk of progression of disease of conduction system, which may result in further blockage and need for intervention (like a pacemaker). However it is purely a theoretical risk and may not occur in your life time. In a large number of patients with this ECG pattern (without symptoms) need of a pacemaker will never arise. More importantly, since it is a degenerative process in majority of patients, we can not do anything to stop it.
Please do write, if there is anything else.
Sincerely
Sukhvinder

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Brief Answer:
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Detailed Answer:
Dear Sir
The ECHO reports reveal enlargement of your left sided chambers and decrease pumping ability of your heart (LVEF 40-45%). Left ventricle also has abnormally thickened walls and decreased relaxability. The exact cause for these changes is not forthcoming from the report. However possible causes can be high blood pressure and obesity.
This is definitely of some concern to me. I would definitely put such a patient on medication in my practice and would like him to reduce his weight also. You need to consult your cardiologist and do get a thorough evaluation.
The non-specific interventricular conduction delay may be secondary to this abnormality on ECHO.
Hope this helps.
Sincerely
Sukhvinder

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Brief Answer:
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Detailed Answer:
Respected Sir
1. The treatment and prognosis (including the reversibility) depends the exact etiology, current status and other existing medical conditions. The damage to heart caused by high blood pressure and obesity is reversible in large number of cases. Definitely whatsoever be the cause for this, weight loss and control of blood pressure are going to be helpful.
2. Since this is an year old report, you need to get a fresh one to look at progression and also need to consult your cardiologist for same.
Sincerely
Sukhvinder

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Brief Answer:
No such limit for PVCs

Detailed Answer:
Dear Sir
PVCs on their own do not have any prognostic value. There is no limit which can differentiate between normal and abnormal. We treat them whenever patient has any symptoms attributable to PVCs , else we do not treat them. A dilated or enlarge heart commonly throws a large number of PVCs. I will be more concerned about knowing other reasons for enlargement of left sided chambers and decreased pumping. Treatment for them will take care of PVCs to a large extent.
Sincerely
Sukhvinder

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Brief Answer:
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Detailed Answer:
Dear Sir
1. Stop worrying that you will have heart attack soon. This data does not suggests so.
2. With an accuracy rate of ~75%, this high level of BNP suggests presence of heart failure. In fact the decreased pumping of LVEF 40-45% itself says decreased heart functions but you should have clinical symptoms too.
3. My concern was that a combination of heart enlargement and decrease pumping may represent a cause of heart failure only (cardiomyopthy), hence it needs to be confirmed. Moderate heart enlargement is not a benign entity, especially when associated with decreased pumping. If you really have heart failure it must be treated. Now this BNP level again points to the same thing (although there are many other causes of raised BNP).
Hence, overall scenario says that you need an examination by a cardiologist , a fresh cardiac ultrasound and may be other blood investigations to sort out the things and start appropriate treatment at earliest.
Hope this clarifies my concern as well as the whole issue.
Sincerely
Sukhvinder

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Brief Answer:
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Detailed Answer:
Dear Sir
1. Yes, A high BP in the range of 197/90 may result in release of BNP but not due to anxiety or panic. How much will be the release is dependent on many factors. If heart is already compromised the rise will be greater. This may also be true that these levels are there prior to index day. I mean they are elevated chronically.
2. It can be released as early as half an hour after the appropriate stimulus. It's half life is ~20 minutes (lowers to half of index value in 20 minutes) {it has two forms with different half lives}.
Sincerely
Sukhvinder

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