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    What do these ECG reports indicate?

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Posted on Mon, 31 Jul 2017 in Hypertension and Heart Disease
Question: I have exchanged email with a cardiologist who said he would need to see my ECG to evaluate as the figures I have copied down look okay. I have upgraded to the specialist option as that may be what I am seeking. My ECG -the pages I got-there are 3 pages-these links have it-they take a minute to load

https://prnt.sc/fsq9tp

http://prntscr.com/fsqdpi

https://prnt.sc/fsqdt5

The date is XXXXXXX 30 this year
doctor
Answered by Dr. Ilir Sharka 3 hours later
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I reviewed carefully your ECG images and would explain that they indicate a low voltage in precordial leads.

This finding could be related to different possible causes:

- myocardial structural damage or cardiomyopathy
- a lung disorder.

For this reason, I would recommend performing further tests:

-a cardiac ultrasound
- a cardiac MRI to examine better the myocardial tissues
- chest X Ray study and pulmonary function tests to exclude a lung disorder.

If suspicions of myocardial ischemia are raised by the above tests a nuclear perfusional cardiac stress test would be necessary.

Considering the episodes you refer, although your symptoms are not typical of a cardiac arrhythmia, I would recommend performing an ambulatory 24-48 hours ECG monitoring to examine your heart rhythm trends for a prolonged time.

Regarding your leg discomfort during the night, I would recommend consulting with a neurologist and performing a nerve conduction study in order to exclude a possible peripheral neuropathy or restless leg syndrome.

You should discuss with your doctor on the above issues.

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 5 hours later
Dear Dr Sharka; I am most grateful for your advice I desperately need, I will take it with me as I hope to see a cardiologist. I am not familiar with these medical terms. I looked them up on google. These two terms myocardial structural damage and cardiomyopathy- google says the heart muscle is damaged. Is that the end?

They have done a pulmonary Xray, because they told me they suspected lung cancer, and ruled it out. They said they found a spot in March which grew and become 2 spots in September 2016.They said these were nodules that can grow into lung cancer. I mean they did an xray again April 2017 only looking at the lung and told me I am clear

Do you know about what it means to have nodules that are often seen in people before they get lung cancer? Are they really dangerous? If they did not grow between September 2017 and April 2017 they could surely decide to grow at any time? I mean based on March 2016 angiogram which they only looked at in July 2016, that I had slightly blocked and narrowed arteries due to plaque but kept it secret and told me "your heart is completely normal, we are only concerned about your lungs"

Please I am very grateful for your advice as i have not had this much advice before,
doctor
Answered by Dr. Ilir Sharka 13 hours later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again dear,

Let me explain as follows:

1- It is true that myocardial structural damage and cardiomyopathy indicate a chronic damage to the myocardial muscle, but it does not mean that the situation is critical. These findings help us find the better treatment options for you, based on the above test results. It is important to find the right diagnosis in order to find the right treatment options. But these findings are not indicative of any end-stage disease. You can still have a normal life expectancy.

2- Regarding the chest nodules, you should know that they indicate enlarged lymphonodules. This clinical finding could be related to inflammation of the lung tissue or could be related to malignancies. But the fact that those spots disappeared in your last chest X ray study, indicates inflammation as the most probable cause of your symptoms. If it were Cancer, your chest X ray study would result really bad and with progression of the spots.

So, I don't think that these enlarged lymphonodules have been indicative of any malignancy. They have been benign inflammatory lymphonodules, which have regressed in your last chest X ray study.

There is nothing to worry about!

3- Regarding the slightly blocked and narrowed arteries, you should know that this can be quite normal at a certain degree considering your age.

But, I would recommend performing a nuclear perfusional cardiac stress test to investigate for the presence of myocardiac ischemia related to coronary artery disease. It is rational to perform this test after a year from your coronary angiogram.

You should discuss with your doctor on the above tests.

Hope to have clarified some of your uncertainties!

If you have any other questions, I would be happy to answer to all of them!

Wishing good health,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 22 hours later
That is extremely helpful. I can't say how grateful I am. Just one more thing, these nodules-they did not say they disappeared, they said they grew between March-September 2016, and in April 2017 they have made no progress. They said all is okay. Actually I don't have any lung symptoms. I just asked if they can grow at any time/ They did not say they disappeared. I had red spots in my mouth a year ago and they are not there any more. Actually father's brother died of lung cancer but he was a very heavy smoker. Two other uncles had lung and throat who never smoked, one died, the other has improved after treatment. So do I have lung cancer genes? Naturally I will call healthcaremagic to say how grateful I am for your information

What I mean is, because these nodules stopped growing, is it what can happen anytime(growing)? Sorry if sounds silly. One of the relatives who got lung and throat cancer-it had spread -he died, the other one is supposed to have got stage 4 throat cancer recently but is getting better.
doctor
Answered by Dr. Ilir Sharka 2 hours later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

The fact that those nodules stopped growing indicates that they are benign, not related to any malignancies.

So, just relax and don't worry about it!

It is true that family history is an important risk factor for lung cancer, but no specific genes have been related to this type of cancer.

Anyway, considering your family history, I would just recommend follow up with chest X ray study every 6-12 months.

Inflammation tests (sedimentation rate, PCR, ESR, complete blood count) are also necessary to investigate for inflammation.

Regarding the red spots in your mouth, they could have been related to an infection or inflammation.

The fact that they disappeared is another argument in favor of inflammation.

There nothing to worry about them!

So, just relax and take it easy!

Hope to have clarified some of your uncertainties!

Wishing good health,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Ilir Sharka

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