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Avatar universal

Borderline EKG

I went to the ER on 3/14 because I felt I was having serious side effects from taking the antibiotic Avelox.  I was dizzy and having palpitations.  

I had an EKG which I was told was normal and I was told to stop the Avelox.  Last week, I decided to ask the hospital for a copy of the EKG for my files and received it today.  I was really upset to see the following findings:

Vent rate:  88 bpm
PR interval:  122 ms
QRS duration:  98 ms
QT/QTc:  380/459 ms
P-R-T axes  78 68 50

Normal sinus rhythm
Possible left atrial enlargement
Incomplete right bundle branch block
Borderline ECG

My understanding is that EKG's are wrong nearly 50% of the time by incorrectly diagnosing left atrial enlargement and also right bundle branch block is often misdiagnosed.  What I don't understand is why would a Dr. tell me it's normal instead of sharing with me that there were slight abnormalities and I should follow up with my doctor to make sure I don't have underlying heart disease?

Also, from what I have read, my QTc is a bit prolonged and he said nothing about it.  Avelox is known to prolong QT intervals. I had a normal EKG in January and my QTc was 420.(I am a female, 3, don't smoke)

Can anyone shed some light on this?  What should I do?  I have had PVC's for a few years now with bouts of sinus tachycardia.  I had a normal echo two years ago and also a holter which justed showed PVC's.
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Avatar universal
Wow, after reading this I had to post. In '04 I took I pill of Avelox prescribed for sinusitis- within a couple hours I started feeling woozy, faint and weak. Soon I got sweaty. Not knowing what's going on I called 911 and was taken to the ER. My bp went to 80/50 and heart rate was in the 50's. Now I have taken so many antibiotics before and never ever had a reaction like this!  They kept me overnight and put me in telemetry, thinking first it was my heart.  Eventually my bp and heart rate went up to normal. NTW I also have a right bundle branch block,  get frequent pvcs but I'm not sure about my Q waves....I have an ecg reading from the date ...long qt is not mentioned.
I thought I was the only one in the world who had a strange reaction to the antibiotic till I read this.
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Avatar universal
Hi, my family has the genetic form of Long QT Syndrome. It sounds like you may have a mild form of Acquired Long QT Syndrome. A QTc of 459 in a women is borderline Long QT but if you are taking a medication known to prolong the QT and your QTc has increased from 420 to 459, I would ask the doctor to take another look and possibly see about changing your meds. Even borderline QT can cause problems in some people.
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84483 tn?1289937937
The EKG is a still a very important test for heart rhythm disorders & possibly identifying abnormalities. The computerized ECG is programmed for all the worst case scenarios, a borderline EKG is probably nothing to be concerned about once your doctor/cardio doubled checked it. All my EKGs were normal, besides one that read mimimal voltage criteria for LVH, could be normal variant, borderline EKG, turned out I do have mild LVH, yet my EKG was termed normal by the cardio, every EKG I had since printed out normal so I think my LVH has probably regressed., but EKGs are infamous for overdiagnosing LVH, atrial enlargement, & prolonged QT intervals, also as the previous poster pointed out for identifying possible infarcts "heart attacks", so while they can be wrong , the good news is when you get a computerized EKG that prints out borderline or normal its usually good news, of course it can print out normal & things can still be wrong, but a computerized EKG that reads borderline and is double checked by the cardiologist and deemed normal shouldn't cause you any worry, my opinion and observations only.
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Avatar universal
The worth of the EKG as a diagnostic tool is not in the "diagnosis" it spits out on the sheet... The worth in them is the information the actual strips give the doctor to read... Heres an example of why a doctor would not share an "abnormal ekg diagnosis"

Ekgs read all  heart rates about 175 as SVT... As im sure many anxiety patients can tell you, their heart rates reach above 175 frequently, in normal sinus rythym... If an ekg diagnoses SVT,  but your cardiologist can clearly see that it is NOT svt, whats the point/ good in telling the patient "my ekg says you have svt but you dont"... Its irrelevent and causes undue stress, as many people can attest to.

However, if you are very concerned, bring it up with your physician, as always.. He/she should be able to explain to you fairly easily why they where not concerned with this reading and whats actually going on.
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Avatar universal
EKG's wrong 50% of the time??  Not what a Cardiologist told me.  I had an EKG one time which said that I had a "previous heart attack", the EKG was done at the ER.  My husband had an EKG done at a Cardiologist's office and his EKG too was spitting out a "previous heart attack".  Neither one of us had a previous heart attack, BUT we had to go through all kinds of tests under the sun to prove that we indeed did never have a heart attack.  We didn't.

We lost all faith in EKG's.  They should go back to the old EKG's or tell the manufacturers who now made the computerized EKG's to find out what causes all these "false heart attacks" spitting out on these EKG's.  And don't think that a Cardiologist can tell you right there and then that it was the computer.  Oh noooooo,  you will have to go through a ton of tests to see whether the computer was wrong or whether you indeed had a heart attack.  Talking about anxiety and suspense till all the test results are reviewed and you are told that your heart is fine and you never had a heart attack.

My and my husband's Cardiologists both told us that "false heart attacks" are showing up frequently on these computerized EKG's only to find out later after the tests that the patient never had a heat attack.
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Avatar universal
Thanks for the replies.  I agree that the strips are what are most important.  It's just that I don't exactly trust ER doctors to read them properly.  I haven't seen a cardiologist in over two years since he first diagnosed me as having "benign PVC's."  I already have an appt. scheduled with my family doctor on Monday so I plan to take a copy of the EKG with me to get his opinion.  He typically has the "leave no stone unturned" approach so I expect that he will refer me back to the cardiologist just so nothing is missed.

I quit taking the Avelox (QT prolonging drug) the day that I was at the ER.  But the ER dr. put me on yet another QT prolonging drug which I took once and did not take again.

I am wondering if the Avelox is to blame for the "borderline" diagnosis.  Perhaps it can cause other problems than a prolonged QT interval.

I just need to stop looking stuff up on the internet.  Everything I have found about incomplete right bundle branch block says anything from completely benign to Brugada syndrome which causes sudden death.
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Avatar universal
its good you are being thorough and seeing your PCP and asking him to interpret your ekg, its a great second step... let us know how it goes and good luck :)
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Avatar universal
Gosh....I meant to say I am 32 not 3!!!
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