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    What do these lab reports indicate?

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Posted on Tue, 8 Aug 2017 in Medicines and Side Effects
Question: Greetings. I have difficulty understanding the differences between the procedure in the doctor's office where they put wires on my chest to check my heart and the other procedure where the technician rolls a device on my chest and watches her computer. I guess one is an EKG and the other a sonogram? What does each procedure actually detect? I had an annual physical today, and await my results, but I am confused about these procedures. My GP is also pressing me to consider the bariatric surgery for weight loss (which requires a 6 month waiting period on a diet according to the health insurance) - I am just not enthusiastic about such interventions (sleeve, belt, bypass). I look forward to your opinions. Thanks.
doctor
Answered by Dr. Geeta Sundar 48 minutes later
Brief Answer:
Hi that is a good question.

Detailed Answer:
Hi that is a good question.
EKG detects electrical activity in the heart. The heart has got a generator that generates electrical activity. As the current passes through rest of the heart, activity in the form of graph is created. By reading this graph, we can judge the rate, regularity of heart beat. If blood supply is deficient in any part--it gives a different signal. This in short is about EKG.
Sonography is based on ultrasound. When the body is bombarded with sound waves, it throws back signals that when recorded tell us if there is any abnormality in soft tissues/organs of body.
Regarding Bariartic surgery. Undergo if---
your BMI is more than 40
You have Diabetes/Pre Diabetes
Blood pressure
Have a strong family history of obesity related heart disease.
Regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Geeta Sundar 37 minutes later
Thank you Dr. XXXXXXX This may get a bit more complicated. When my GP was trying to persuade me to go for a bariatric consult he made a comment about "a little thickness" (which he never mentioned before). Is that detected on the EKG?

For some strange reason (!) my BP was 110/60 (it is usually at home 130/85 or so), and of course I think my BMI is around 40. I discussed the belt with a secretary (61 years old) who did it 2 years ago, and she lost 90 pounds, BUT it has aspects that I am a bit uneasy about. In any case I look forward to your comments and will hopefully let you know about my blood/urine results when I get them.
doctor
Answered by Dr. Geeta Sundar 4 hours later
Brief Answer:
a little thickness could mean a slight hypertrophy

Detailed Answer:
Hi a little thickness could mean a slight hypertrophy (increase in muscle thickness) of heart and this may be the reason he has recommended the Bariatric surgery.
You are right about not getting it done unless really needed. Can you send me the EKG written report (not the tracing)
Was a 2D Echo also done?
In the sonography report, is there a fatty liver?
Yes revert back with reports.
Regards
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Geeta Sundar 1 hour later
Thank you. I will upload as soon as all the results are obtained.
doctor
Answered by Dr. Geeta Sundar 4 hours later
Brief Answer:
Ok

Detailed Answer:
Ok
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Geeta Sundar 3 days later
Hello, Dr. XXXXXXX As promised I received my cardio EKG and Doppler test results. The doctor mentioned a slight thickening of heart muscle, but the attached pages raise a bit of alarm in me regarding these assorted abnormalities especially hypertrophy, "blocks" etc., even if described as mild.
My blood work was basically within normal ranges except for testosterone at 253 which would seem very low for my age of 61.
I look forward to your views on these issues. Thank you.
doctor
Answered by Dr. Geeta Sundar 12 hours later
Brief Answer:
I saw your EKG report. The echo report is faint and unreadable.

Detailed Answer:
Hi XXXXXXX I saw your EKG report. The echo report is faint and unreadable.
The heart has an electrical generator called SA node. From this the electric current called heart beat is generated. This stimulates pumping action of heart leading to blood being pumped to the body.
When there is any disturbance in this electrical activity pathway--it is called 'blocks'.
In your case there is right bundle (mild) and left anterior hemi block. These are not so significant as the main pumping action is from Left ventricle. If there is 'Left bundle branch block' it is significant, which is not there in your case.
You also have slight thickness or hypertrophy of heart muscles.
I would not do any drug intervention for low testosterone.
Best advise I can give is exercise enough--cardio, brisk walking, uphill walking, swimming.
Regarding Bariartic surgery, if at any time you feel you are not able to exercise because of your weight, undergo the surgery.
All the best.
Regards

Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Geeta Sundar 2 hours later
Thank you for your reply. The ECG report has several "blocks" listed at the top including that bundle block. Are each of these "mild", can they worsen and how do they originate? I don't remember them being listed on previous tests including the last ECG from 3 years ago. It all seems rather alarming.

Also, which areas of the report are faint that I could try providing you that have necessary information? Should I visit a cardiologist? Thanks.

My options for extensive exercise are limited because of gait problems resulting from childhood foot surgery to straighten it because of monoplasia (posterior tibial transfer). I have a stationary bicycle..
doctor
Answered by Dr. Geeta Sundar 4 hours later
Brief Answer:
All the 'blocks' are electrical conduction defects.

Detailed Answer:
Hi All the 'blocks' are electrical conduction defects. As of now none of them are serious. But yes they can progress.
Yes there is also left axis deviation and low progression of 'R' wave in ECG. This may indicate a cardiac problem.
The whole echo report is faint. Can you type out the final report for me (at the end)?
Stationary cycling is also good if you have a foot problem.
No harm in seeing a Cardiologist for a second opinion for your over-all condition especially to decide whether Bariartic surgery is indicated.
Regards

Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Geeta Sundar 1 hour later
Thank you. Should I retype the material off of which page? The numbers on the report or the numbers on the page of the graph? Also, about the left axis deviation, what serious or not serious possibilities could it represent? Thanks.
doctor
Answered by Dr. Geeta Sundar 19 minutes later
Brief Answer:
I want the final report of 2D Echo--not the graph.

Detailed Answer:
I want the final report of 2D Echo--not the graph. I have seen the graph. It is clear.
Regarding Left axis deviation do not worry it is not significant. It does not represent or will represent anything serious--
Regards

Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Geeta Sundar 37 minutes later
Thank you, so I'll type up the numbers above the graph such as for QRS, PP, etc.??
doctor
Answered by Dr. Geeta Sundar 10 hours later
Brief Answer:
No--it is the other 'non-graph' report you have sent that is faint---regard

Detailed Answer:
No--it is the other 'non-graph' report you have sent that is faint---regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Geeta Sundar 48 minutes later
I am attaching my typed list of those categories and numbers. Thank you. Please see attachment.

Dr. XXXXXXX I was just told by my brother (58 years old) that last year he was diagnosed with the right bundle branch block, but we have no knowledge if either of our parents or any other relatives have had this problem. In addition, we have had longevity in the parts of our family as well as problems of obesity. Evidently this syndrome appears in the late 50s of some people who otherwise have had no problems.
doctor
Answered by Dr. Geeta Sundar 3 hours later
Brief Answer:
Your 2D Echo is normal and you have a good cardiac reserve

Detailed Answer:
Great! Your 2D Echo is normal and you have a good cardiac reserve as indicated by left ventricular ejection fraction.
Regarding Right bundle branch, again do not worry. I have several patients with RBBB for 20-25 years who undergo even major surgery without problems.
You do not have to undergo Bariartic surgery for any heart problem.
Continue with stationary biking and diet to lose weight.
Regards


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

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