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What Do The Following ECG Results Indicate?
Question: "This question to be addressed to Dr.Ilir Sharka,Cardiologist"
Hello Again Dr. Sharka,
This is XXXXXXX again. It took me longer to obtain my latest ECG. Forwarding; as per your request, the following ECGs: Aug.30, Oct.26, and Nov.10,2016. Hopefully the uploaded ECGs are clear enough for you to analyse. Thank you for your professional approach to handling my concerns and questions.
Regards, XXXXXXX
Hello Again Dr. Sharka,
This is XXXXXXX again. It took me longer to obtain my latest ECG. Forwarding; as per your request, the following ECGs: Aug.30, Oct.26, and Nov.10,2016. Hopefully the uploaded ECGs are clear enough for you to analyse. Thank you for your professional approach to handling my concerns and questions.
Regards, XXXXXXX
Brief Answer:
I would explain as follows:
Detailed Answer:
Dear XXXXXXX
Welcome back on HCM!
I carefully reviewed all your uploaded ECG and would explain that the main findings in these ECG are:
- the presence of incomplete right bundle branch block (iRBBB)
- left anterior fascicular block (LAFB)
- a borderline PR interval duration (up to 90 msec)
- prominent P wave in leads DII, DIII, aVF
- presence of q waves in septal leads.
Now let me explain the potential reasons for the above ECG findings:
1- The presence of iRBBB and LAFB coupled with borderline PR and q waves in septal leads may be an expression of cardiac conductance system abnormalities.
2- The prominent P wave and iRBBB may be related to a chronic pulmonary disorder.
3- The presence of septal q waves may be explained by:
- septal fascicular block,
- chronic pulmonary disorder
- inter-ventricular septal hypertrophy.
Coming to this point, as the ECG is a test that may help in the differential diagnosis of several health disorders, but should be coupled with additional medical tests in order to arrive to an exact diagnosis, I would recommend performing the following tests:
a- a trans-thoracic cardiac ultrasound (echo), for investigating the cardiac structure and function
b- chest X ray study, pulmonary function tests, arterial blood gas analysis, to rule in/out any possible pulmonary dysfunction
c- a 24-48 hours ambulatory ECG monitoring (Holter) to investigate for any possible hidden cardiac conductance system dysfunction (sick sinus syndrome).
I recommend discussing with your attending doctor on the above mentioned issues.
Hope to have clarified your uncertainties!
And please remember to follow my tips regarding Roemheld syndrome, in order to avoid possible exacerbation of this disorder.
I remain at your disposal for any further questions!
Wishing you a pleasant weekend!
Regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Dear XXXXXXX
Welcome back on HCM!
I carefully reviewed all your uploaded ECG and would explain that the main findings in these ECG are:
- the presence of incomplete right bundle branch block (iRBBB)
- left anterior fascicular block (LAFB)
- a borderline PR interval duration (up to 90 msec)
- prominent P wave in leads DII, DIII, aVF
- presence of q waves in septal leads.
Now let me explain the potential reasons for the above ECG findings:
1- The presence of iRBBB and LAFB coupled with borderline PR and q waves in septal leads may be an expression of cardiac conductance system abnormalities.
2- The prominent P wave and iRBBB may be related to a chronic pulmonary disorder.
3- The presence of septal q waves may be explained by:
- septal fascicular block,
- chronic pulmonary disorder
- inter-ventricular septal hypertrophy.
Coming to this point, as the ECG is a test that may help in the differential diagnosis of several health disorders, but should be coupled with additional medical tests in order to arrive to an exact diagnosis, I would recommend performing the following tests:
a- a trans-thoracic cardiac ultrasound (echo), for investigating the cardiac structure and function
b- chest X ray study, pulmonary function tests, arterial blood gas analysis, to rule in/out any possible pulmonary dysfunction
c- a 24-48 hours ambulatory ECG monitoring (Holter) to investigate for any possible hidden cardiac conductance system dysfunction (sick sinus syndrome).
I recommend discussing with your attending doctor on the above mentioned issues.
Hope to have clarified your uncertainties!
And please remember to follow my tips regarding Roemheld syndrome, in order to avoid possible exacerbation of this disorder.
I remain at your disposal for any further questions!
Wishing you a pleasant weekend!
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Dr. Iliri,
I am in agreement with your explanation of Roemheld Syndrome as a strong possibility based on my symptoms. I have made adjustments to eating smaller meals spread through a 24 hr. period. Have positive results.
I have found an excellent site with a 58:18min. radio audio recording by Dr. Miachael XXXXXXX on: Roemheld Syndrome - The Gastric - Cardiac Connection.
Very informative on the RS symptoms, solutions and the misdiagnosis by most doctors. The 'comments' on the site were very helpful.
Link:http://superhumanradio.com/490-roemheld-syndrome-the-gastric-cardiac-connection.html
I have registered with HCM for monthly unlimited questions.
I would appreciate retaining your professional services as my HCM Cardiologist.
I am forwarding a copy of my doctor's referral letter to a Cardiologist dated Nov.9,2016. It is unfortunate that unless it is considered an emergency; the wait time to see a specialist with the initial appointment could be 6-7 months, in Canada.
I have located a private cardiology clinic in Canada and am exploring possibilities of using their services for the tests you have recommended.
If the link to Dr.Miachael Smith's RS audio does not work. I could do an Upload File. Please let me know.
Thank you.
Regards, XXXX
I am in agreement with your explanation of Roemheld Syndrome as a strong possibility based on my symptoms. I have made adjustments to eating smaller meals spread through a 24 hr. period. Have positive results.
I have found an excellent site with a 58:18min. radio audio recording by Dr. Miachael XXXXXXX on: Roemheld Syndrome - The Gastric - Cardiac Connection.
Very informative on the RS symptoms, solutions and the misdiagnosis by most doctors. The 'comments' on the site were very helpful.
Link:http://superhumanradio.com/490-roemheld-syndrome-the-gastric-cardiac-connection.html
I have registered with HCM for monthly unlimited questions.
I would appreciate retaining your professional services as my HCM Cardiologist.
I am forwarding a copy of my doctor's referral letter to a Cardiologist dated Nov.9,2016. It is unfortunate that unless it is considered an emergency; the wait time to see a specialist with the initial appointment could be 6-7 months, in Canada.
I have located a private cardiology clinic in Canada and am exploring possibilities of using their services for the tests you have recommended.
If the link to Dr.Miachael Smith's RS audio does not work. I could do an Upload File. Please let me know.
Thank you.
Regards, XXXX
Brief Answer:
My answer as follows:
Detailed Answer:
Dear XXXXXXX
I am glad that my tips are helping you go through this situation!
I carefully passed through your uploaded referral letter, and would explain that it seems to be a normal overview of your clinical situation.
You should discuss with the new doctor on the above issues and also about Roemheld Syndrome as a possible cause of all your symptoms.
Regarding the radio program, you can follow it regularly as you find it helpful!
But, I would also explain that every case is different and the problem is more complex considering the thyroid problems and sleep apnea.
So, every individual is different and things on the internet can be sometimes misleading, especially depending on the individual characteristics (age, gender, lifestyle, comorbidities, etc.).
I would be happy to be your personal online cardiologist.
You can ask me directly at any time on my personal link:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765
Regards,
Dr. Iliri
My answer as follows:
Detailed Answer:
Dear XXXXXXX
I am glad that my tips are helping you go through this situation!
I carefully passed through your uploaded referral letter, and would explain that it seems to be a normal overview of your clinical situation.
You should discuss with the new doctor on the above issues and also about Roemheld Syndrome as a possible cause of all your symptoms.
Regarding the radio program, you can follow it regularly as you find it helpful!
But, I would also explain that every case is different and the problem is more complex considering the thyroid problems and sleep apnea.
So, every individual is different and things on the internet can be sometimes misleading, especially depending on the individual characteristics (age, gender, lifestyle, comorbidities, etc.).
I would be happy to be your personal online cardiologist.
You can ask me directly at any time on my personal link:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765
Regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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