What does my ECG test report indicate?

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Posted on Tue, 26 Apr 2016 in Hypertension and Heart Disease
Question: Hi Doctor,
I have been to see my doctor this morning to get a copy of my ECG Report.
I am male, aged 53 years, weight 13 Stone.
I fell asleep at the wheel and woke after a couple of seconds with my car at the other side of the road.
Nobody was injured.
The results were as follows:-
P/PR=114/160 ms
QRS=88 ms
QT/QTc=372/371 ms
P/QRS/T Axis=48/47/46 deg
Heart Rate : 59 BPM


Other printed information on the ECG Report
**sinus rhythm(slow)
**slight left -precordial repolarization disturbance, consider ischemia, LV overload or aspecific change, small negative in T in V5 V6
**Borderline ECG

**a consultant wrote on the ECG report "Sinus Bradycardia at 59/min....Could do 24 hour ECG"

Can you please advise what the above means and would you recommend further tests and if so what tests.?
When they say "consider ischemia" ,on the ECG report ,does that mean I definitely have ischemia or perhaps I might have it ?
The ECG report at the end stated "unconfirmed report". What does that mean?

Please advise on the above.
My email is YYYY@YYYY and my XXXXXXX number is (07478)490404.
At present I am off work at the request of my agent.

Regards
XXXX



doctor
Answered by Dr. Ilir Sharka 56 minutes later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello XXXXXXX

Welcome on HCM!

Regarding your concern, I would explain that your ECG parameters (P/PR; QRS; QT/QTc; P/QRS/T Axis) are within normal range.

So, you shouldn't worry about!

Heart rate 59 bpm is quite a slight bradycardia, commonly found at certain periods in normal individuals.

Also, those prescribed non-specific repolarization changes in left precordial leads should be differentiated between a left ventricular systolic overload due to hypertension, a valvular disorder like aortic stenosis, left ventricular hypertrophy, or even cardiac ischemia.

Cardiac ischemia is less likely to be an explanation of your ECG findings, as you have not any clear cardiac ischemia symptomatology (no chest pain, dyspnea, etc); and you don’t refer any coronary risk factors.

Do you suffer from hypertension? Diabetes or dyslipidemia?

Do you smoke?

Any family history of CAD (coronary artery disease)?

Coming to this point, it is necessary to perform some medical tests as follows:

- Fasting blood glucose,
- Blood lipid profile,
- BUN & creatinine,
- Cardiac ultrasound (ECHO)
- Blood electrolytes level

For investigating any possible coronary risk factors, as well as to confirm/exclude any cardiac structural abnormalities (left ventricular hypertrophy, valvular dysfunction, etc.).

The most important issue to consider in this history is your clinical symptomatology.

Just a few seconds sleepiness while driving is not considered sufficient to raise strong suspicions about cardiac ischemia.

If your heart rhythm is persistently slow (persistent bradycardia), then an ambulatory 24 to 48 hours ECG monitoring (Holter) would be necessary for investigating a possible sick sinus syndrome (which could be an explanation of your episodic sleepiness).

But, you should know that an episodic sleepiness could be also:

- Transient hypotension,
- Hypoglycemia,
- Sleep apnea syndrome,
- Neurogenic syncope, etc.

That’s why, I recommend you performing the above mentioned tests.

I would like to directly review your ECG recording.

Could you upload it here when available?

Hope to have been helpful to you!

Feel free to ask me again in case of any further uncertainties.

Kind regards,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 17 minutes later
Hi Doctor Iliri,

Thank you very much for your detailed reply.It is most informative and helpful.
Before I upload my ECG Report for your review and before answering your questions in the body of the report above ,can you confirm if there will be any further charges.I have paid 35GBP so far.Just need to be clear before i proceed.
Thanks for your assistance so far.

Best Regards

XXXX
doctor
Answered by Dr. Ilir Sharka 7 hours later
Brief Answer:
You are welcome!

Detailed Answer:
Hello again, dear XXXXXXX

I would like to explain that you can make two other follow up questions included in your payment.

So you don't need to pay any more, if you continue with our opened query.

I would be glad to review your medical reports (tests) and give my professional opinion.

Wishing you a pleasant weekend!

Regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 21 hours later
Hi Doctor Sharka,

Thanks for your previous reply.I have now uploaded my original ECG Report for your further review as requested.
Further to queries you had raised in your previous e-mail:-


**I don't suffer from hypertension or diabetes.
--Fasting Glucose Level test showed Normal levels.
--I don't know if i have transient hypertension or hypoglycemia or neurogenic syncope as stated in your email.
--I was tested for Sleep Apnea by my doctor on the scoring test website and it appears to be normal(score was three on range zero to eleven for normal range)
**Last time i smoked was nearly 20 years ago and i have not smoked for 20years
**As regards Coronary Artery Diseases(CAD) my mother died at age 65 years from a heart attack.She was diagnosed as having angina by the doctor in the town and that diagnosis was held for many years until the post-mortem indicated that she had advanced Coronory Heart Disease instead.

**I should also mention that i feel fatigued ,tired and lethargic most of the time.This has been going on for quite a considerable period of time.Whereas about 5- 10 years ago i could do gardening for most of the day at the weekend. Nowadays after over an hour and a bit ,i feel exhausted and i have to rest.

Enjoy your weekend
and thanks for your information

Best Regards

XXXX



doctor
Answered by Dr. Ilir Sharka 2 hours later
Brief Answer:
I would explain:

Detailed Answer:
Dear XXXXXXX

I carefully reviewed your uploaded ECG recording and would explain that nothing wrong could be found.

Your resting ECG is within normal ranges.

You shouldn’t worry about!

It seems that you have a major non-modifiable coronary risk factor (heredity for CAD, as your mother has suffered from premature coronary heart disease).

I recommend following a healthy diet and life-style, keeping that way any possible modifiable coronary risk factors under control in the future.

Meanwhile, I still insist performing the medical checkup with the above mentioned tests, also including thyroid function test (FT3, FT4, TSH), which could exclude/confirm any thyroid dysfunction responsible for you easy tiredness and bradycardia.

A Holter monitoring would be advisable if your bradycardia is persistent.

Wishing you a good health!

Greetings!

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

Cardiologist

Practicing since :2001

Answered : 7231 Questions

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