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What Does The Following EKG Report Indicate?
Question: i am a 44 y/o male(I'm a surgeon)with no PMH. Perfect health. Bodybuilder with intense workout regimen 6-7 days per week for 1-2 hours per day. Meds include adderal 15 mg bid, HRT testosterone cypionate 100 mg IM q week.
No symptoms whatsoever. Excellent cardiovascular tolerance.
Recent routine physical revealed the following on EKG: left axis deviation, LBBB, anterior ST elevation(consider acute infarct)
I'm obviously not having an infarct. I've read a good bit already and looks like athletes heart vs hypertrophic cardiomyopathy. Thoughts?
No symptoms whatsoever. Excellent cardiovascular tolerance.
Recent routine physical revealed the following on EKG: left axis deviation, LBBB, anterior ST elevation(consider acute infarct)
I'm obviously not having an infarct. I've read a good bit already and looks like athletes heart vs hypertrophic cardiomyopathy. Thoughts?
Brief Answer:
Could be athlete's heart or cardiomyopathy
Detailed Answer:
Hi, thank you for using Healthcare Magic. I agree you're not having an acute infarct. Your thoughts about athlete's heart or hypertrophic cardiomyopathy are right on. The best way to distinguish between these is an echocardiogram.
It is important to get the correct diagnosis as hypertrophic cardiomyopathy is a cause of sudden death in athletes, as I'm sure you know. I would also want to be sure the LBBB is not due to a primary problem in the electrical conduction system of your heart vs a complication of cardiomyopathy.
The presence of LBBB makes it difficult to evaluate other cardiac lesions using the EKG and invalidates stress tests. If you need to have a stress test, it must be done with imaging modalities (such as echo) to get a more accurate picture of ventricular function and the potential for CAD.
My suggestion is that you see a cardiologist and start with an echocardiogram. The echo could detect valvular abnormalities, outflow obstruction from hypertrophy, chamber enlargement, and other lesions. From there, further evaluation of the electromechanical system can be done. You might want to find a cardiologist who is experienced with those types of problems (ie can do electromechanical testing).
Hope this answers your query. If you have further questions, I would be happy to answer them.
Could be athlete's heart or cardiomyopathy
Detailed Answer:
Hi, thank you for using Healthcare Magic. I agree you're not having an acute infarct. Your thoughts about athlete's heart or hypertrophic cardiomyopathy are right on. The best way to distinguish between these is an echocardiogram.
It is important to get the correct diagnosis as hypertrophic cardiomyopathy is a cause of sudden death in athletes, as I'm sure you know. I would also want to be sure the LBBB is not due to a primary problem in the electrical conduction system of your heart vs a complication of cardiomyopathy.
The presence of LBBB makes it difficult to evaluate other cardiac lesions using the EKG and invalidates stress tests. If you need to have a stress test, it must be done with imaging modalities (such as echo) to get a more accurate picture of ventricular function and the potential for CAD.
My suggestion is that you see a cardiologist and start with an echocardiogram. The echo could detect valvular abnormalities, outflow obstruction from hypertrophy, chamber enlargement, and other lesions. From there, further evaluation of the electromechanical system can be done. You might want to find a cardiologist who is experienced with those types of problems (ie can do electromechanical testing).
Hope this answers your query. If you have further questions, I would be happy to answer them.
Above answer was peer-reviewed by :
Dr. Raju A.T
I was unable to find nuch on LBBB and Athlete's heart. Would you by chance have any literature on that or be able to direct me?
Brief Answer: XXXXXXX Heart Association
Detailed Answer:
The XXXXXXX Heart Association has a journal, Circulation, which has addressed a variety of heart problems over the years. They also put out frequent guidelines for physicians to help manage numerous cardiac conditions. You should be able to find a number of articles on these topics. Many of the articles, particularly guidelines, are available without need for a subscription. You can look on their website http://circ.ahajournals.org/ and do a search for articles in their archives.
By the way, the term I should have been using was electrophysiologic rather than electromechanical testing.
Detailed Answer:
The XXXXXXX Heart Association has a journal, Circulation, which has addressed a variety of heart problems over the years. They also put out frequent guidelines for physicians to help manage numerous cardiac conditions. You should be able to find a number of articles on these topics. Many of the articles, particularly guidelines, are available without need for a subscription. You can look on their website http://circ.ahajournals.org/ and do a search for articles in their archives.
By the way, the term I should have been using was electrophysiologic rather than electromechanical testing.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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