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Heart Disease (Expert Forum)
atrial enlargement
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atrial enlargement
by Bob !, Jul 01, 2003 12:00AM
I am 50 year old male and on my ECG strip says "RATE 70, PR 184,QRSD 79,QT 350,QTc 378,--AXIS-- P 64,QRS 2, T 26,Normal sinus rhythm,rate 70.....Normal P axis,PR,rate & rhythm;Consider left atrial enlargement.....P V1 - .10 mV or more negative; -OTHERWISE NORMAL ECG-." 1.What does this mean,especially "Consider left atrial enlargement.....P V1 - .10 mV or more negative."2.Is mild left atrial enlargement reversible if it is caused by (a) excessive jogging and running and (b) excessive jogging and running plus high normal blood pressure (at doctor's office 130/84,but at home 110/74)? If yes how?3.Is mild left atrial enlargement,like an stretched elastic which once gets stretched never can return to a normal size?4.Are old mild heart attacks most of time reported in writtings(sentence) on an ECG strip?5.How are old mild heart attacks reported and written on ECG strip and are ECGs,most of the time for the rest of one life,written as "ABNORMAL ECG","OTHERWISE NORMAL ECG" or BORDERLINE ECG"Thanks
Doctor's Answer
by CCF-M.D.-RCJ, Jul 01, 2003 12:00AM
Bob !,
Thanks for the post.
Reading about an ECG is like reading about the Mona Lisa, you can read all you want but you don't know what in the hell you're talking about until you see it in person.
Several useful points can still be made, however:
(1) Computers put those sentences at the top of ECGs -- they are frequently wrong.
(2) The accuracy of diagnosing left atrial enlargement by ECG is less than 50%! The ECG can be relied upon to diagnose left atrial enlargement if (1) the ECG change is very pronounced (not "consier left atrial enlargement"), (2) if other factors on the ECG support left atrial enlargement, such as left ventricular hypertrophy, or (3) if the clinical scenario fits, such as in a person with atrial fibrillation.
(3)Mild left atrial enlargement alone would not be something I would ever think twice about, even if it was confirmed by echo.
(4) I know of no mechanism by which aerobic exercise could cause left atrial enlargement, and I certainly would never counsel someone to stop jogging based on an ECG that stated "consider left atrial enlargement".
(5) When a computer recognizes a heart attack on the top of the ECG, the strip will say something like: "anterior myocardial infarction, timing unknown". It would be coded as an abnormal ECG.
Hope that helps.
Thanks for the post.
Reading about an ECG is like reading about the Mona Lisa, you can read all you want but you don't know what in the hell you're talking about until you see it in person.
Several useful points can still be made, however:
(1) Computers put those sentences at the top of ECGs -- they are frequently wrong.
(2) The accuracy of diagnosing left atrial enlargement by ECG is less than 50%! The ECG can be relied upon to diagnose left atrial enlargement if (1) the ECG change is very pronounced (not "consier left atrial enlargement"), (2) if other factors on the ECG support left atrial enlargement, such as left ventricular hypertrophy, or (3) if the clinical scenario fits, such as in a person with atrial fibrillation.
(3)Mild left atrial enlargement alone would not be something I would ever think twice about, even if it was confirmed by echo.
(4) I know of no mechanism by which aerobic exercise could cause left atrial enlargement, and I certainly would never counsel someone to stop jogging based on an ECG that stated "consider left atrial enlargement".
(5) When a computer recognizes a heart attack on the top of the ECG, the strip will say something like: "anterior myocardial infarction, timing unknown". It would be coded as an abnormal ECG.
Hope that helps.
