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What Does The Following ECG Report Indicate?
Question: Last Friday at work I was feeling unwell, and a couple of times felt that I was passing out when I stood up. BP was 120/70. Hr was 47. I had an ECG, which showed a sinus bradycardia of 44, which lasted for four hours when I was in A&E being monitored, and which has remained at a similar rate since. I am anaemic at 95, apparently I do not need iron supplements for this. I lost about 2 stones around December time without having to try.
Have you any idea what may be wrong?
Have you any idea what may be wrong?
Brief Answer:
I suggest you some opinions to follow.
Detailed Answer:
Hello! Thank you for asking on HCM! Regarding your concern, first I would recommend to rule out any serious cardiac conductance impairment related to those passing out episodes.
(1) An ambulatory 24 to 48 hours ECG monitoring is necessary to confirm. You refer for a sinus bradycardia for 4 hours; is it really sinus bradycardia?!! Or, is it a sino-atrial exit block? Are there episodes of atrioventricular block during all day-night stream-line?!! All the above dilemmas should be carefully ruled out.
(2) The second point to clear out is your anemia.
As you refer its cause is not defined yet. If it is not iron deficiency, then other reasons should be ruled out. I would recommend some paths to follow for a differential diagnosis: first an infectious agent should be ruled out such as borreliosis (it may affect the heart conductance system, giving rise to heart block; show anemia, besides other organ involvements). Did you experience muscular pain?!! Any articular pain?!! Any migrans cutaneous erythema before(a bullseye shaped rash appearing to move from one place to another)?!! Subfebrile temperature??!! Any prior visit to an endemic tick borne areas?!! An infectious diseases specialist coupled with special lab tests could be of help here.
A second opinion is to rule out a neoplastic disease; if a megaloblastic anemia is confirmed, then the first cause to rule out is a tumor somewhere in the body (initiating from the digestive system, and so on).
A third opinion is an infiltrative and granulomatose systemic disease like sarcoidosis, interfering with the cardiac electrical conductance system (complicated with cardiac block); also causing anemia.
(3) A third point to discuss is the possibility of a conjoint effect of sinus bradycardia and anemia in producing these orthostatic phenomena (passing out mainly when standing up). A Tilt Up Table test would be helpful.
Nevertheless, though there are some different directions to explore, at the end I recommend you to investigate your potential heart rhythm and conductance problems, and to look after your anemia for a possible cause (it may be the key of our responses).
Hope to have been helpful to you!
Feel free to ask me whenever you need! Greetings from Dr. Iliri.
I suggest you some opinions to follow.
Detailed Answer:
Hello! Thank you for asking on HCM! Regarding your concern, first I would recommend to rule out any serious cardiac conductance impairment related to those passing out episodes.
(1) An ambulatory 24 to 48 hours ECG monitoring is necessary to confirm. You refer for a sinus bradycardia for 4 hours; is it really sinus bradycardia?!! Or, is it a sino-atrial exit block? Are there episodes of atrioventricular block during all day-night stream-line?!! All the above dilemmas should be carefully ruled out.
(2) The second point to clear out is your anemia.
As you refer its cause is not defined yet. If it is not iron deficiency, then other reasons should be ruled out. I would recommend some paths to follow for a differential diagnosis: first an infectious agent should be ruled out such as borreliosis (it may affect the heart conductance system, giving rise to heart block; show anemia, besides other organ involvements). Did you experience muscular pain?!! Any articular pain?!! Any migrans cutaneous erythema before(a bullseye shaped rash appearing to move from one place to another)?!! Subfebrile temperature??!! Any prior visit to an endemic tick borne areas?!! An infectious diseases specialist coupled with special lab tests could be of help here.
A second opinion is to rule out a neoplastic disease; if a megaloblastic anemia is confirmed, then the first cause to rule out is a tumor somewhere in the body (initiating from the digestive system, and so on).
A third opinion is an infiltrative and granulomatose systemic disease like sarcoidosis, interfering with the cardiac electrical conductance system (complicated with cardiac block); also causing anemia.
(3) A third point to discuss is the possibility of a conjoint effect of sinus bradycardia and anemia in producing these orthostatic phenomena (passing out mainly when standing up). A Tilt Up Table test would be helpful.
Nevertheless, though there are some different directions to explore, at the end I recommend you to investigate your potential heart rhythm and conductance problems, and to look after your anemia for a possible cause (it may be the key of our responses).
Hope to have been helpful to you!
Feel free to ask me whenever you need! Greetings from Dr. Iliri.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Answered by
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