right atrial enlargement?

[john_2215]

i have done an ecg last 2 yrs and it came back border line with early repolarization  but i did an ecg yesterday and it reads
Rate 93: sinus rhyrhm ......... Normal p axis ,v-rate 50-99
Right atrial enlargement .....p>0.25mv 2lds or <-0.24mv avr/avl
Pr133 :st elivation,probable normal early repol. Pattern ... St elivation age <55
Qrsd 85
Qt 356
Qtc 443
Axis:
P   84
Qrs  79
T 68
It also listed as abnormal ecg but the doctors said it is normal my heart was beating fast at time of ecg cause i was nervous just decided to do one because i felt some plapitations with my heart beating like it wanted to stop  and it was scary i got 2 doctors to look at it for me and dey said its normal but y did the ecg come back abnormal and with right atrial enlargement im 22 years of age and not familly history of heart problems i have no high bloos pressure or diabeties pls help i knw it may be hard for u all to explain to me what it means without u all seeing the actual ecg but any informtion is needed and as i have said the fron the 2 doctors said that the ecg is normal but pls give me a reason why it came back the way it did thank u!

[CCFHeartMD18]

Hi john_2215,
I totally understand your concerns.  Let me try and explain the ECG findings.  The ECG machine uses pre-specified parameters when calculating whether or not a certain measurement is "normal" or "abnormal."  These values are obtained by sampling a large population of people and determining what the average values are and then use statistical analysis to determine cut-off values for defining "abnormal."  

In this case the computer read abnormal likely because you have early repolarization and right atrial enlargement.  Early repolarization is quite common in young people such as yourself.

Right atrial enlargement is a difficult diagnosis to make on an ECG alone and typically has no clinical significance in the absence of other clinical findings.  

The good news on the ECG is that there was nothing serious found such as an arrhythmia.  

Hope that helps to clarify!

[Iatrogenic]

I think that the only way you will feel okay about this is to insist that both doctors explain why the test is listed as "abnormal."  It's reasonable to assume that you well understand the definition of "abnormal."  To suggest that "abornormal" is "normal" results in cognitive dissonance, (call it the bs meter), of great proportions.  You deserve to know why.  You will, I am sorry to say, have to ask again.  But that may not even help because you might be given inane answers.

There are patients who have become experts at interpreting test results like this in view of other medical history.  I'm not one of them.

My problem is the opposite -- being told it looked like I had a bigdeathscenario-type result, when, later at the ER, there was nothing.  Not only that, but the ER MD - I swear this is the case - made it sound as if I was the one who had sent me there directly from the primary docs office, and as if I had been the one who said, "Oh look, there's a myocardial infarction."  It wasn't, of course.

Then, there's the interesting fact that it has been three days and I have had not one word from the primary doctor.  You would think he sends people in droves directly from his office to the ER, so no big deal.

Yesterday, I was very comfortable with the idea of ignoring all but the most gross symptoms and saying the heck with anthing that wasn't, and the heck with the primary doc entirely.  I felt great.  Today, because I'm not an MD, I'm again concerned.  The anxiety this is producing HAS to be worse than whatever is(n't) wrong with me, you know?

You deserve a rational explanation.  I deserve an apology and a rational explanation.  Will we get them?  If we don't - how long to stay on the treadmill of "what-ifs?"  The length of time it took to post this is far too long.  Best of luck.