question-icon

What does this ECG report indicate?

default
Posted on Wed, 25 Nov 2015
Question: Hi i have a ecg readout i would like an oppinion on, if its arrythmia or normal.
I have previously worn holter monitors that showed pvcs but nothing to be worried about. But i bought my own holter monitor because i did not feel the same symptoms when i had the recordings, and wanted to make sure i have recordings of my bad periods.
3 different recordings here, first was taken last night as i was feeling dizzy and unable to relax while watching tv. second was taken while sleeping and i keep waking up at night. third felt like a pvc (as im having every minute) but looked different to the others.

My symptoms other consists of random dizzyspells, trouble staying asleep, sudden muscle cramping and twitching, nausea, chestpain.
doctor
Answered by Dr. Benard Shehu (43 minutes later)
Brief Answer:
Following advice...

Detailed Answer:
Hi and thank you for asking!
I read your query and review your monitor pictures very carefully.

On the first two recordings your heart rhythm is normal apart from tachycardia. On the third file is recorded a premature ventricular complex (PVC s). All the three findings explain most of your symptoms and you shouldn't worry about them.

Tachycardia and PVC s aren't harmful to you but they are responsible for increase stress and anxiety that are manifested with your symptoms (random dizzy spells, trouble staying asleep, sudden muscle cramping and twitching, nausea, chest pain etc.).

If you were my patient would recommend to do the following examinations to exclude any problems:
- blood work including thyroid hormone levels
- Cardiac Echo
- Stress test
- chest x-ray
- abdominal echo

If all the above mentioned examinations are normal than your problems are definitely related to anxiety.

Meantime, I would recommend to do as follows:
- Avoid unnecessary stress
- Increase physical activity
- Quit smoking
- Avoid drinking alcohol, carbonated drink/energy drink and cafe
- Use Magnesium supplements
- Use chamomile tea

Hope this will be of help!
Wish you health!
Dr. Shehu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Benard Shehu (38 minutes later)
Hi and thanks for the reply.

From your recommendations i have already done the following without any result.
-thyroid normal
-cardiac echo normal
-chest x-ray normal
-abdominal echo

I have suspected thyroid problems before but all tests have been normal. Yet some claim that normal ranges they test for may not be normal for everyone.

I do not smoke (altho i used another form of nicotine that i quit a few months ago), i have not had alcohol in 2 months, staying away from coffee and i have been taking magnesium but it doesn't do much.

I have a previous problem with anxiety and panic attacks and i have valium which i can take when it gets too bad (once a week at the most) but this does not seem to relieve any of the other symptoms just makes me more indifferent to them.

So what you are saying is that my heartrythm constantly jumping around from 50-70 while relaxing is normal and i should not worry about it? (i sometimes have a resting rate as low as 40 which i also find strange as im not an athlete)

The heart symptom i have not been able to record yet is a sudden jump of the heartrate to 120+ that lasts for 4-10 seconds. from what i read it sounds like unsustained vtach. this only happens a couple of times a week but is very uncomfortable.
doctor
Answered by Dr. Benard Shehu (1 hour later)
Brief Answer:
Following advice...

Detailed Answer:
Hi back,

It's a great thing that the test were all normal and this is why you shouldn't worry about tachycardia. tachycardia is harmless in otherwise normal heart.

Moreover, you shouldn't be afraid you don't have ventricular tachycardia because t never happen in patients with a normal heart.

What you are experiencing is related to stress and anxiety. Anxiety disorders are associated with increased adrenaline release which is responsible for the jumping of HR from 70 to 120+ bpm.

This is why you should continue with the above mentioned measures and try to control your anxiety.

Hope this will be of help!
Wish you health!
Dr. Shehu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Benard Shehu (3 days later)
Im having a little trouble understanding your oppinion on my ecg readouts.

Firstly you say it is tachycardia, but my heartrate is under 60 which would imply the opposite, that it's bradycardia. And my jump in heartrate do not excede 100, which tachycardia should?

Also when standing up my heartrate will jump from (just checked now) 59 to 91. IS this normal? I read about POTS but this seems to require a sustained increase in heart rate, mine is just temporary.

I was given beta blockers a year ago when i was last having problems with alot of PVCs. But i did not use them much. And now im afraid of using them because of my low resting heart rate.

Is my irregular heartbeat something that should be treated? As iv said treating anxiety (with valium) does not seem to relieve any of my heart symptoms.

Also i read about roemheld syndrom, which could be responsible for multiple cardiac symptoms without anything being found, and i do have alot of problem with bloating and gas that seem to be the main cause of RS. Any thoughts about this?

Thanks for your time.
doctor
Answered by Dr. Benard Shehu (5 hours later)
Brief Answer:
Following advice.

Detailed Answer:
Hi back,

After reviewing and measuring again Your HR on the ecg you provided I can confirm that on the third ecg jus before the PVC your HR is 105 bpm (as I said the only findings are PVC and tachycardia). Since the HR is above 100 bpm it's called tachycardia.

It's very normal for HR to go from ~60 bpm to ~90 bpmwhen you go from laying down to standing and you shouldn't worry about that to.

You shouldn't worry about POST your symptoms and signs aren't suggestive for it.

Gastric acid reflux, flatulence and spastic colitis may be the cause and a consequence of anxiety and all the efforts should be done to relieve gastrointestinal symptoms.

It's a well known fact that patients with GERD (acid reflux) manifest Roemheld syndrome. This is why I strongly recommend:
- eat often and in small portions
- avoid spicy food
- use antacids otc (malox)
- use PPI otc (prilosec)

Wish you health!
Dr. Shehu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Benard Shehu

Cardiologist

Practicing since :2004

Answered : 2257 Questions

premium_optimized

The User accepted the expert's answer

Share on
What does this ECG report indicate?

Brief Answer: Following advice... Detailed Answer: Hi and thank you for asking! I read your query and review your monitor pictures very carefully. On the first two recordings your heart rhythm is normal apart from tachycardia. On the third file is recorded a premature ventricular complex (PVC s). All the three findings explain most of your symptoms and you shouldn't worry about them. Tachycardia and PVC s aren't harmful to you but they are responsible for increase stress and anxiety that are manifested with your symptoms (random dizzy spells, trouble staying asleep, sudden muscle cramping and twitching, nausea, chest pain etc.). If you were my patient would recommend to do the following examinations to exclude any problems: - blood work including thyroid hormone levels - Cardiac Echo - Stress test - chest x-ray - abdominal echo If all the above mentioned examinations are normal than your problems are definitely related to anxiety. Meantime, I would recommend to do as follows: - Avoid unnecessary stress - Increase physical activity - Quit smoking - Avoid drinking alcohol, carbonated drink/energy drink and cafe - Use Magnesium supplements - Use chamomile tea Hope this will be of help! Wish you health! Dr. Shehu