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Dr. Andrew Rynne

Family Physician

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What does my ECG report indicate?

Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 5894 Questions

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Posted on Fri, 1 Jun 2018 in Hypertension and Heart Disease
Question: Hello Dr. yesterday during a routine visit I...
Resolved • Response time 1 minute
Hello Dr. yesterday during a routine visit I asked physicians assistant for a 12 lead ekg as I have heard it is a good thing to do. Never had any symptoms, slightly overweight, bp great with 10/propanolol and 10/lisinipril, male 41, no family history. PA came back and said ekg abnormal and asked if I've ever experienced the symptoms of a heart attack? We'll just nearly then I did! I have a copy of my ekg, machine printed "abnormal old anterior infarct" I have an appointment with a cardio but I'm going crazy until next week. Are these ever false?
I have PDF of trace
doctor
Answered by Dr. Ilir Sharka 18 minutes later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome on Healthcaremagic!

I understand your concern and would explain that this ECG pattern (abnormal old anterior infarct) could be mimicked by several clinical conditions such as hypertrophic cardiomyopathy (interventricular septal hypertrophy),certain cardiac conductance abnormalities such as septal fascicular block or Left Bundle Branch Block, a certain chest structure, etc..

An abnormal ECG is not a sufficient criteria to confirm a myocardial infarct, whenever it has happened. A clinical symptomatology (chest pain, shortness of breath)and abnormal lab tests are necessary to confirm the diagnosis.

So, you shouldn't worry too much about this issue.

Nevertheless, I would like to directly review your ECG report for a more professional opinion.

Could you please upload it for me to review as attachment to this questions?

I remain at your disposal for any further questions, whenever you need!

Kind regards,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 7 minutes later
Yes, how do I upload PDF? Again, my dr was on vacation and this was done by nurse tech and I was seen by physician assistant. I requested the ekg because I am a pilot training for airline transport.Figured it out! Ekg uploaded. I might add she seemed to put the electrodes on quite quickly and did not place limb leads on limbs but on upper body instead. Don't know if any of that matters
doctor
Answered by Dr. Ilir Sharka 6 minutes later
Brief Answer:
There is no signs of past myocardial infart in this ECG.

Detailed Answer:
Hello again!

You uploaded successfully your PDF and I reviewed it.

I am glad to confirm that it does not indicate any signs of old anterior infarct.

Your ECG pattern is compatible with increased thorax volume (due to obesity and misplacement of the precordial chest ECG electrodes). This explains low voltage QRS complexes and a poor progression of the R waves in the antero-septal leads (V1-V3).

But, there is nothing abnormal!

As a cardiologist, I can assure you about that!

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

Hope you will find this answer helpful!

Wishing all the best and a Happy New Year,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka 4 minutes later
Brief Answer:
You are welcome!

Detailed Answer:
I am glad to have been helpful to you!

If you will have any other uncertainties in the future, I would be happy to answer to all of your questions.

You can ask me directly if you wish.

Wishing good health and a Happy New Year,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 1 minute later
Thank you so much for taking the time to review the ekg and provide such a detailed answer!Here is input from an online dr I had submitted my ekg for review before you but he just now responded. You feel like your observations are more valid, yes?
doctor
Answered by Dr. Ilir Sharka 18 hours later
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again!

I reviewed the other doctor opinion, but my judgement on your ECG does not change.

It indicates a low voltage of QRS in the precordial leads and this happens in certain conditions such as:

- chronic pulmonary disease (COPD, Emphysema)
- when the electrodes are more distant to the cardiac muscles and this happens in overweight or obese patients.

Furthermore this altered spacial relationships between the heart and the chest wall (due to overweight) may lead to QRS axis deviation in the horizontal plane and the poor progression of the R waves in the antero-septal leads (V1-V3).

In addition, when the chest electrodes are displaced lower (in an intercostal space below than usual) these abnormal findings may be more prominent.

This explains your ECG pattern and does not indicate any past myocardial infarct.

So, there is nothing to worry a about!

This is just an incidental finding,which can be explained as above.

I would recommend performing a new ECG and performing a cardiac ultrasound when consulting with your cardiologist.

Hope you will find this answer helpful!

Best wishes,

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