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What Does My ECG Test Report Indicate?

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Posted on Tue, 21 Jun 2016
Question: having Episodes of palpitations and dizziness from past few years , have done ECG , ECho , TMT everything was normal . one ECG was done yesterday night during the event of palpitation , please help to check the reports from yesterday and old ecg /echo reports from November 2015.
doctor
Answered by Dr. Anantharamakrishnan (1 hour later)
Brief Answer:
No serious abnormality seen / need further assessment

Detailed Answer:
Hi friend
Welcome to Health Care Magic

A normal ECHO is reassuring… your heart is structurally normal

ECGs show “Incomplete Right Bundle Branch” pattern – which could be a normal variant. It could be from abnormality in right side of heart – excluded here because of normal ECHO. Hence the episode may from the nerves of the heart….

Anaemia / Anxiety / Alcohol / Tobacco (smoking) / Caffeine (too much tea, coffee, cola) / Fever / Infection / Pain / Stress / Thyroid / Medicines like Phenylephrine used for ‘cold’; Salbutamol used for asthma and so on - may be responsible....
At times, abnormal nerve paths in the heart (bypass tracts) or disease of the conduction system may be responsible!

Standard ECG records the electrical activity of the heart, for a few seconds. It can detect the arrhythmia occurring during that time only. If the episode occurs randomly- one needs Holter or event monitor – HOLTER records for days; Event Monitor for weeks… Holter records continuously; Event Monitor only at certain times

Many cases of palpitation are benign, especially when associated with normal ECHO and may not require treatment, If you also have symptoms like blurred vision, loss of consciousness, shortness of breath, chest pain along with this, you need urgent work up
Specific treatment may not always be necessary.

Have a second opinion / have a Holter
If negative, have an Event Monitor
If there are no clues and if the problem is still bothering to the extent of interfering with life style, there are advanced techniques of investigations of increasing complexity – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. There are other advanced treatment modalities - like ablation (thermal or radio-frequency), which could be done during EPS. Though the test is the gold standard, it is INVASIVE and hence is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST.

The treating doctor may suggest them depending on need, based on his assessment of the situation.

Good luck
God bless you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anantharamakrishnan (18 minutes later)
thanks sir for the detailed answer . Palpitations comes and goes it is not always persistent . Yesterday when I did echo palpitations and feeling of blurred vision was there but ecg came normal . If it is due to some muscle spasm or nerve related which specialist to consult ? I have already consulted general physicians , cardiologist , Gastro , did endoscopy , ultrasound , chest x ray , extensive blood tests but everything looks OK . I am 29 years ,6 ft tall and weight is 52 kg which is constant from 5 years , gets muscle spasm in chest or stomach after exercise or playing which makes the whole body uncomfortable .
doctor
Answered by Dr. Anantharamakrishnan (1 hour later)
Brief Answer:
Likely Stress / Get Holter

Detailed Answer:
Hi

     The description suggests possible Anxiety – A psychiatric assessment and assistance can help. No need to feel diffident to see a psychiatrist...seeing a cardiologist does not mean heart disease. The specialist can rule out or rule in by making appropriate diagnosis. Social and occupational situations may be responsible….

Muscle spasm does not cause palpitation

Anyway, get 24-hour ambulatory monitoring of the heart rate (Holter) done – palpitation needs to be DOCUMENTED by ElectroCardioGram (EKG) for further appropriate action

     You are underweight… Your BMI is 16 / 60 to 80 kg will be in normal range. Have thyroid tested. You should see a good DIETICIAN - One generally needs SEVERAL sessions, to master concepts of calories, nutritional values, biological value, vitamins, minerals and so on… You need advice on both quantity and quality of food

Regards
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
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Dr. Anantharamakrishnan

Cardiologist

Practicing since :1966

Answered : 4505 Questions

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What Does My ECG Test Report Indicate?

Brief Answer: No serious abnormality seen / need further assessment Detailed Answer: Hi friend Welcome to Health Care Magic A normal ECHO is reassuring… your heart is structurally normal ECGs show “Incomplete Right Bundle Branch” pattern – which could be a normal variant. It could be from abnormality in right side of heart – excluded here because of normal ECHO. Hence the episode may from the nerves of the heart…. Anaemia / Anxiety / Alcohol / Tobacco (smoking) / Caffeine (too much tea, coffee, cola) / Fever / Infection / Pain / Stress / Thyroid / Medicines like Phenylephrine used for ‘cold’; Salbutamol used for asthma and so on - may be responsible.... At times, abnormal nerve paths in the heart (bypass tracts) or disease of the conduction system may be responsible! Standard ECG records the electrical activity of the heart, for a few seconds. It can detect the arrhythmia occurring during that time only. If the episode occurs randomly- one needs Holter or event monitor – HOLTER records for days; Event Monitor for weeks… Holter records continuously; Event Monitor only at certain times Many cases of palpitation are benign, especially when associated with normal ECHO and may not require treatment, If you also have symptoms like blurred vision, loss of consciousness, shortness of breath, chest pain along with this, you need urgent work up Specific treatment may not always be necessary. Have a second opinion / have a Holter If negative, have an Event Monitor If there are no clues and if the problem is still bothering to the extent of interfering with life style, there are advanced techniques of investigations of increasing complexity – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. There are other advanced treatment modalities - like ablation (thermal or radio-frequency), which could be done during EPS. Though the test is the gold standard, it is INVASIVE and hence is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. The treating doctor may suggest them depending on need, based on his assessment of the situation. Good luck God bless you