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What Does The ECG Exam Result Indicate?
Question: ECG exam result, "Possible left atrial abnormality". I am 44 year old male, fit as a fiddle, athletic my entire life, involved in intense exercise since age 15. I am a non-smoker, rarely drink. Only issue has been slightly elevated blood pressure (130/80). My ECG offered Vent Rate: 68 bpm, RR Interval 872 ms, PR Interval 162 ms, QRS Duration 108 ms, QT Interval 410 ms, QTc Interval 424 ms, QT Dispersion 64 ms, PRT Axis 69/63/47. What data within the results lends to 'Left atrial abnormality'? I swim 1/2 mile every day, ride my bike all summer, and body build in the gym. Included an image of my ECG. . .thank you.
Brief Answer:
Some features of left atrial abnormality are found.
Detailed Answer:
Hi,
Thanks for writing to us. As I understand you had undergone ECG when you are asymptomatic with healthy life style and the EGG strip is reported as left atrial abnormality with normal measures. You wish to understand what features indicated left atrial abnormality in the ECG. You will need to be familiar with various waves and leads found in the ECG to understand that. Perhaps you may want to read about those various waves especially the P wave and leads on google.
Now, your ECG shows broad P waves in lead II and AVF and also negative component in P wave in lead V1. The P waves in lead II are just wider than half of the large squares or more than 2.5mm, so in AVF. These findings in the ECG suggest that they are P-mitrale, i.e. left atrial abnormality is present.
Now for some further discussion, your ECG is almost good except for left atrial abnormality. Now, this occurs due to any condition in which left ventricular filling pressure is increased. I would like to know if you have any symptoms:
1. Do you ever have shortness of breath? Is it associated with exercise? Do you have SOB at rest?
2. Do you ever have ankle swelling, night cough etc.?
3. Have you seen a cardiologist? Have you undergone further evaluation?
Regards,
Dr. Kaushik Sarkar
Some features of left atrial abnormality are found.
Detailed Answer:
Hi,
Thanks for writing to us. As I understand you had undergone ECG when you are asymptomatic with healthy life style and the EGG strip is reported as left atrial abnormality with normal measures. You wish to understand what features indicated left atrial abnormality in the ECG. You will need to be familiar with various waves and leads found in the ECG to understand that. Perhaps you may want to read about those various waves especially the P wave and leads on google.
Now, your ECG shows broad P waves in lead II and AVF and also negative component in P wave in lead V1. The P waves in lead II are just wider than half of the large squares or more than 2.5mm, so in AVF. These findings in the ECG suggest that they are P-mitrale, i.e. left atrial abnormality is present.
Now for some further discussion, your ECG is almost good except for left atrial abnormality. Now, this occurs due to any condition in which left ventricular filling pressure is increased. I would like to know if you have any symptoms:
1. Do you ever have shortness of breath? Is it associated with exercise? Do you have SOB at rest?
2. Do you ever have ankle swelling, night cough etc.?
3. Have you seen a cardiologist? Have you undergone further evaluation?
Regards,
Dr. Kaushik Sarkar
Above answer was peer-reviewed by :
Dr. Prasad
1. I never have shortness of breath.
2. I exercise 4-6 days a week since age 15, and I am now 44 years old. I have been a competitive, successful athlete my entire life.
3. I am extremely fit, no swelling in my ankles.
4. I do not have night cough.
5. I've had borderline hypertension on/off for about 15 years.
6. I have never taken any medication.
Thank you.
2. I exercise 4-6 days a week since age 15, and I am now 44 years old. I have been a competitive, successful athlete my entire life.
3. I am extremely fit, no swelling in my ankles.
4. I do not have night cough.
5. I've had borderline hypertension on/off for about 15 years.
6. I have never taken any medication.
Thank you.
Brief Answer:
Echocardiography is needed.
Detailed Answer:
Hi, thanks for the reply.
As I can see here, you don't have any suggestive symptom of congestive heart failure, nor of any other cardiac problem.
I think you want to know the reason for such findings in your ECG. I will explain the same to you.
Left atrial abnormality in ECG may be due to several disease conditions. Some important ones are Congestive cardiac failure, which seems to be less likely from your answers. But, clinical examination by a local cardiologist is also needed to exclude the same.
Secondly, disease involving heart valve, like mitral regurgitation also has this finding in ECG. Similar finding is observed in case of dilated cardiomyopathy, and this is a common cardiac morbidity among athletes. Both the conditions can be ruled out by an Echocardiography.
Now the most important issue is that you are a known hypertensive for long time. Among hypertensive patients left atrial enlargement and consequent left atrial abnormality is very common, even in the early stage of disease.
Therefore, provisionally I think that this finding in ECG was due to your long standing hypertension. But, then also other worrisome diseases should be excluded.
So, you can follow the below mentioned advice -
1. Salt restricted diet
2. Continue regular exercise
3. Avoid oil consumption more than 2tablespoons per day
4. Strict control of blood pressure
5. Echocardiography
6. Cardiologist consultation
7. Blood for HbA1c, fasting TSH, and lipid profile
You can get back to me once you have the echocardiography report for follow up.
If you find this answer helpful, please close the thread and rate my answer.
Regards
Dr Kaushik Sarkar
Echocardiography is needed.
Detailed Answer:
Hi, thanks for the reply.
As I can see here, you don't have any suggestive symptom of congestive heart failure, nor of any other cardiac problem.
I think you want to know the reason for such findings in your ECG. I will explain the same to you.
Left atrial abnormality in ECG may be due to several disease conditions. Some important ones are Congestive cardiac failure, which seems to be less likely from your answers. But, clinical examination by a local cardiologist is also needed to exclude the same.
Secondly, disease involving heart valve, like mitral regurgitation also has this finding in ECG. Similar finding is observed in case of dilated cardiomyopathy, and this is a common cardiac morbidity among athletes. Both the conditions can be ruled out by an Echocardiography.
Now the most important issue is that you are a known hypertensive for long time. Among hypertensive patients left atrial enlargement and consequent left atrial abnormality is very common, even in the early stage of disease.
Therefore, provisionally I think that this finding in ECG was due to your long standing hypertension. But, then also other worrisome diseases should be excluded.
So, you can follow the below mentioned advice -
1. Salt restricted diet
2. Continue regular exercise
3. Avoid oil consumption more than 2tablespoons per day
4. Strict control of blood pressure
5. Echocardiography
6. Cardiologist consultation
7. Blood for HbA1c, fasting TSH, and lipid profile
You can get back to me once you have the echocardiography report for follow up.
If you find this answer helpful, please close the thread and rate my answer.
Regards
Dr Kaushik Sarkar
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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