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EKG Results and diagnosis ref: My question on 8/13
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EKG Results and diagnosis ref: My question on 8/13


  Here is the original question posted on 8/13/98:
  : Hello, I have written here before concerning PVC's I get, and I thank you all for all that you are doing for us.
  : I came back from an EKG test done on me today and am quite worried over the results. I have a family history of heart problems, Grandfather age 88 still living but has had a heart bypass, an Uncle who had a quad bypass another Uncle with tachycardia and my Mother died at the age of 47 of a massive heart attack. I am a smoker 1/2 my life now, but am weening off of them, and want to quit but I guess not bad enough to just throw them away , but I will, especially as I get older and see the bad things it can do.
  : My past EKG's have shown abnormal, but I don't know exactly if it was just what was written on top or the actual readings, but I did have a heart cath in Feb. of 97 and it showed that my heart was in good shape, but the heart cath was ordered because my cardio lite test showed something in the left side of my heart the left lower chamber or something like that, now to go back further the cardio lite test was ordered because the Doctor told me that I had abnormal EKG's.
  : Below is what it reads on top of my EKG
  : ***************************************************************************
  : Vent. rate 69 bpm
  : PR interval 188 ms
  : QRS duration 102 ms
  : QT/QTc 372/398 ms
  : P-R-T 49 -68 35
  : Normal sinus rhythm
  : Left anterior fascicular block
  : Cannot rule out Inferior infarct (masked by fascicular block?), age undetermined
  : Abnormal ECG
  : ***************************************************************************
  : So thats it, this is why I am worried now I was told before that the Doctors go by the actual readings and not the top part of the EKG results and my wife is trying to convince me that they wouldn't have let me leave if the technician had seen anything out of the ordinary, she says that they are trained to recognize things in EKG's that would warrant further steps while I was there if anything was really wrong. The EKG was ordered by my primarry care physician for just a routine check up and to rule out that the chest pain and tightness is caused by my fibromyalgia and not my heart and I have to start exercising because of the fibro condition.
  : Please if you can shed any light on any of this respond before the weekend because as much as I worry about my heart I am going to be in a state of panic until Tuesday.
  : Thank you in advance,
  : Dave Ponticelli
  ---------------------------------------------------------------------------------------------------------------------------------
  Dear Dave
  The fact that your mother died at a young age of a massive heart attack is a scary thing. It is wise to be concerned about your increased risk for having heart disease. The computerized EKG reading at the top of the EKG follows a complex algorithm, but is sometimes wrong. The technicians that obtain them may or may not notice important abnormalities. You should call your doctor and find out if he thought your EKG was OK (I suspect it is). It sounds like you have had an extensive cardiac work-up already. Of course, you are still at risk for developing heart disease in the future and should continue to be vigilant.
  Having said this, I do think you would be much better off focusing your time and energy on making positive changes in your life instead of worrying so much about your health. In other words, you need to STOP SMOKING. Especially in someone with such a strong family history of heart disease, if you were going to do one thing to decrease your chance of developing heart disease, it would be to stop smoking.
  I hope this is useful. Good luck. Feel free to write back with further questions.
  ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
  Now to my question:
  I was called Monday from my primary Doctor and he said that he was concerned with my EKG, and told me that if I have any chest pains before I came in to see him on Tuesday to go to the ER. From what he told me, he was concerned because the EKG was abnormal and didn't match up to a previuos one that he had on file. Well I went in today and he had already  consulted with my Cardiologist and the Cardiologist looked at my EKG from 1996 and said that there was no change from then and I would imagine from the 1997 EKG's. My Doctor went on to explain that since I had had a heart cath in 1997 and it showed a normal heart that I am ok, and that some people just have abnormal EKG's and always will. He told me not to worry about it, but for precautions he wants to check my heart in the future, like next year. As you can see on the results above it says something about left anterior fascicluar block and I guess I also have shown some abnormal T waves on previous EKG's.
  When you have the time can you please explain to me why I have abnormal results and what is happening here to me. And also what is an abnormal T wave, does that or any of these results have anything to do with stress? Or do I just have a weird functioning heart? Can any of these things cause my PVC's?
  Any light you can shed on this would be greatly appreciated.
  Thank You in advance,
  Dave Ponticelli
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Dear Dave, thank you for your question.  It sounds like your heart catheterization showed completely normal coronary arteries and normal left ventricular pumping function.  Thus, the results of your ECG do not indicate that you now have coronary disease.  An ECG is never 100% accurate regarding coronary disease as the heart cath is, so the results can be misleading on the ECG.  Left anterior fascicular block (LAFB) is a benign conduction system abnormality that won't affect you at all.  Because LAFB is seen in the inferior leads of the ECG, it can simulate an old inferior myocardial infarction when in fact,  that never occurred at all.  Also, the inferior leads of the ECG are notorious for being inaccurate in revealing prior evidence of a myocardial infarction.  The t-wave abnormalities noted on your ECG are also benign and are frequently seen in young patients who have completely normal hearts like yours.  The bottom line in this message is that you have a normal heart, other than PVCs, and you are not at risk for having a heart attack or sudden cardiac death.  Your physician is appropriately cautious but you must learn to not focus on cardiac disease that isn't there - your cardiac catheterization proved that point.  As you mentioned in your prior question, you are still smoking.  This habit is contributing to your PVCs and I strongly advise to cease all tobacco use.  You may also notice that your PVCs will decrease when you do this.  Finally, you must remember that the heart forum is for general informational purposes only and we are not able to make diagnoses.  Thus, your cardiologist and other physicians are the best resource for future questions and concerns.  They sound like they're doing an excellent job in providing you with medical care and I think you should heed their advice.  Information provided in the heart forum is for general purposes only.  Specific diagnoses and therapies can only be provided by your physicians.




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