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What Does My ECG Report Indicate?

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Posted on Fri, 20 Nov 2015
Question: Hello,
During a recent ECG in the D.R., my heart rate varied between 61 and 82 (ECG) report included.
Is this OK, or something of concern? (Blood pressure normal, physical exam, all good.)
Thank you, xxxxx
doctor
Answered by Dr. Ilir Sharka (2 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello xxxx!

Thank you for asking once again on HCM!

I carefully reviewed your uploaded ECG and would like to explain that the reason why your heart rate has varied within such values (61-82 bpm) is the presence of ectopic beats present in some of the recordings.

This has lead to an incorrect calculation of heart rate by the ECG machine (erroneously measuring the distance between a normal and an ectopic heart contraction instead of a normal R-R interval). That's why the heart rate has jumped from 62 pbm to 82 bpm.

Coming to this point the most important issue to investigate your case is the study of extrasystolic arrhythmia (shown by those ectopic beats on your ECG).

For this reason I recommend you to perform an ambulatory 24-48 hours ECG monitoring (Holter).

Further lab tests like:

- complete blood count
- thyroid hormone levels
- blood electrolytes
- blood urea and creatinine
- fasting glucose
- cardiac ultrasound
- a chest x ray study

are needed to explore possible causes of cardiac arrhythmia.

Hope to have been helpful!

Feel free to ask any other questions, whenever you need!

Greetings!

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (3 days later)
Hello Dr. Sharka,

Please indicate if the extrasystolic arrhythmia is atrial or ventricular.What prompted me to get a phis exam and ECG, was that when I climb the 65 steps from the beach to my house which I have been doing for years, I found myself
getting faint and exhausted and having to stop and rest half way up. Is this most likely due to the heart condition, or a low red blood cell count indicated on my physical exam (12 and 37 hematocrito)?
The doctor in the DR prescribed me to take "Isorrit 200 mg (amiodarona)" every 12 hrs. which I have been reluctant to take, and have not. What is your opinion on this? Thank you very much for your help, xxxx
doctor
Answered by Dr. Ilir Sharka (38 minutes later)
Brief Answer:
My opinion:

Detailed Answer:

Hello again xxxx!

Regarding your concern, I would explain that those ectopic beats seem most probably to be supraventricular aberrant ectopic beats.

Nevertheless, the fractionated ECG makes it difficult to explore all the components in the underlying differentiation.

As I recommended above, an ambulatory ECG monitoring (Holter test) is necessary to thoroughly investigate the present extrasystolic arrhythmia (qualitatively and quantitatively).

Only after such a study and after getting the results of the above recommended other lab tests (to identify possible responsible triggering factors), an appropriate therapy could be instituted.

When you get those tests (including complete blood count, etc) done please upload them for a direct review!

I agree with you that starting amiodarone would be quite unacceptable in your case.

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (3 days later)
Hello Dr Sharka.
During my ECG, how many ectopic beats occurred?
Is this condition alone possible cause for exertional pre syncope?
If there are no other heart issues, is this condition problematic/dangerous,
or basically harmless?
Tanks again, xxxxx
doctor
Answered by Dr. Ilir Sharka (13 hours later)
Brief Answer:
I would explain:

Detailed Answer:

Hello again, dear XXXXXXX

Your uploaded ECG demonstrated frequent ectopic beats (in fact bigeminy is present: that is an ectopic beat after every normal beat).

But, a single resting ECG could not be sufficient to conclude about the quantitative issues of arrhythmia. A new Holter monitoring is necessary.

I would also recommend performing an exercise cardiac stress test to investigate the heart and body response during physical exertion (to clarify the potential exertional presyncope occurrence from arrhythmia)..

We can't conclude about the severity of a potential arrhythmia without first considering its quantitative aspect (Holter results), cardiac structure and function (cardiac ultrasound and cardiac stress test).

You should discuss with your attending cardiologist about the possibility of checking the above mentioned issues.

Kind 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
doctor
Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9536 Questions

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What Does My ECG Report Indicate?

Brief Answer: I would explain as follows: Detailed Answer: Hello xxxx! Thank you for asking once again on HCM! I carefully reviewed your uploaded ECG and would like to explain that the reason why your heart rate has varied within such values (61-82 bpm) is the presence of ectopic beats present in some of the recordings. This has lead to an incorrect calculation of heart rate by the ECG machine (erroneously measuring the distance between a normal and an ectopic heart contraction instead of a normal R-R interval). That's why the heart rate has jumped from 62 pbm to 82 bpm. Coming to this point the most important issue to investigate your case is the study of extrasystolic arrhythmia (shown by those ectopic beats on your ECG). For this reason I recommend you to perform an ambulatory 24-48 hours ECG monitoring (Holter). Further lab tests like: - complete blood count - thyroid hormone levels - blood electrolytes - blood urea and creatinine - fasting glucose - cardiac ultrasound - a chest x ray study are needed to explore possible causes of cardiac arrhythmia. Hope to have been helpful! Feel free to ask any other questions, whenever you need! Greetings! Dr. Iliri