Tests

[SF1]

Hello:
Anything worth following-up on with a cardiologist on the ecg posted here:

http://home.earthlink.net/~n9577w/      
(might have to scroll to see all of it)

History:
• Two ECGs –1 year apart both indicating “abnormal” -No previous ECGs except from a life insurance application (presumably nothing clinically sig. - I got the insurance).
• Cholesterol 279 total/63hdl/182ldl - not on med of any kind -No syncope - 39 years old – generally very healthy - No chest pain -Reasonably active and run occasionally - Good diet but 10 lbs overweight
• Family history of CAD – grandparents both sides had strokes, atherosclerosis, or heart attacks but died in old age.  Father - high cholesterol, linear defect in the anteroapical  portion of the left ventricle, AV block 1st degree, and is alive and well in old age (no cardiac events).  Mother no issues.
• No other risk factors except diagonally creased earlobes (if that truly is the phenotype for something that makes it worth mentioning).

GP referred me to a cardiologist however I did not follow through.  The GP’s comment re. the ecg was “A 39 year old shouldn’t look like this”. But My reading indicates issues on my ecg are not clinically significant unless newly acquired.  

1. Does the ECG look like anything that truly needs follow-up in an otherwise healthy person?
2. What tests would you normally expect to resolve any questions raised by the ecg?  If I go should I insist on a thallium stress test to eliminate false positives and need for more tests?

Thank You.

[CCF-M.D.-RCJ]

Sf1,

Thanks for the post, but holy mackarel I had to wait a long time to see that EKG!

My interpretation of the EKG is that it shows sinus bradycardia with Right bundle branch block (RBBB).

RBBB can rarely occur in an otherwise normal heart. In a study of 237,000 airmen under age 30, for example, 394 cases of complete RBBB were found, representing an incidence of 0.2 percent. Ninety four percent of these subjects had a normal cardiovascular examination and the course was benign, with only one subject requiring a pacemaker in 10 years.  In another prospective study of 855 men followed for 30 years, the incidence was 0.8 percent in subjects at age 50, 9.9 percent by age 75 and 11.3 percent by age 80. There was no significant association with risk factors for or the presence of ischemic heart disease, myocardial infarction, or cardiovascular deaths, suggesting that RBBB is usually a marker of a slowly progressive degenerative disease that also affects the myocardium. Similar observations apply to left bundle branch block.

In someone who otherwise has a normal cardiac exam, I do not routinely order additional testing for a RBBB.

Hope that helps.

[SF1]

Dr. - Thank you.  I appreciate your time and opinion.

Hankstar - I agree, GP seemed a bit too reliant on the computer diagnosis/tolerance for what is probably a normal variant (appreaciate though that he recognized need to get someone else's pov if he was unsure).  Thanks.

[3rdMajor]

My cholesterol fluctuated around 215-230.  My GP toyed with the idea of initiating statin therapy, but never got around to it.
At 47, I was 6'2" 200 lbs, played basketball 4x a week at the YMCA.  I had hernia surgery in 6/02 and had an EKG.  I was pronounced "healthy as a horse".  Prior resting EKG and ECG were normal.  I developed angina in 11/02, and had a resting EKG immediately following the afternoon basketball.
It showed ischemia.  I had a heart cath, and was recouperating from 5x bypass within a week.  I guess the moral of the story is that with today's diagnostics, you are healthy as a horse right up until the time you have a massive coronary.If I were you, I would inquire about statin therapy.  Cholesterol of 279 is a risk factor for CAD.

[kate38]

HELP!!!!!

[kate38]

Hankstar,

Sorry,I apolgize.I have greatly appreciated your help.

I'm just really frustrated,with this meds thing,I'm at the point of flushing them all down the **.

What I'm looking for is information on reaction to catapres patch and clonidine,if you have a reaction to one will a reaction happen with the other.Also side effects of minoxidil, since he might increase that one as well.

If your not sure thats fine,and I don't expect you to no everthing. Just looking for a little direction as to were I might find out about some of the meds I take.

It's just very confusing,you read the side effects of different drugs and they say don't stop them or, if certain side effects occur contact the doctor.

You have been a great help,just by responding to my post,thank you.Also,you mentioned in one of your prevous post you had a 17 year old son,I have a 18,16 and 15year old. I wonder how much of the raised blood pressure is do to our children reaching teenage years.(just kidding,my childeren are my life).
Sorry,Thanks again.
K


Thanks Bunches
Kate

[chapo]

Hi, I noticed in the original question this person mentioned creased earlobes. Does anyone know much about this. I have family history of CAD and the very beginings of ear creases, my father has them and after his bypass operation they decreased in depth in both ears.