Long QT on one ecg

Hello, I went to a new pcp for a checkup and he heard a heart murmur, which he said was probably normal but told me to see a cardiologist to be safe.  He also told me the nurse was going to give me an ecg before I left.  I had the ecg and left the office.  About 20 minutes later the receptionist called me and said the doctor wanted me to come back to get the ecg results to take to the cardiologist.  He had writted "prolonged QTc" on the ecg.  the QT interval was 480 ms and the QTc was 468 ms.  When I went to the cardiologist he asked why I was referred and I told him because of the heart murumer.  He listened to my heart and said the murmur sounded benign but he was going to do an echo a week later to be sure.  He did an ecg and aparently it was okay.  Right before he was about to leave I asked if he wanted to see the ecg results from my doctor and he said he didn't need to.  I told him that my doctor had written long QTc on the results but didn't tell him the number.  He looked at the ecg he had just done (not the one with the long qt) and said it was slightly longer but normal.  I don't know what that number was.  I went back to my PCP yesterday and he asked if i had seen the cardiologist yet.  He told me what had concerned him in my last ecg was that the qt interval was too long.  He said if i had a long qt we had to be careful what medicines I can take.  I told him what happened and that I didn't show him the original ecg and that the cardiologist didn't seem concerned.  He said, something like "well maybe it was only that one test.", and said he would wait to get the results back and keep on him about the qt.  I had the echo this morning and the cardiologist said the murmur was innocent and that there was some leaking at the valve but no ones heart is perfect.  He said my heart was fine.  My question is why would the qt be long in one ecg and not that other?  Can the ecg be wrong?  Since I told the cardiolgist I was there for a murmur instead of the qt and he never actually saw the ecg with the long qt, could it have been missed?  Is there another possible reason for a qt to be long once?  

[michellepetkus]

What I have found is cardiologist are way more calm about heart issues than other health professionals, even the nurses working in their offices.  Most people tend to totally freak out at the slightest thought of a heart issue and the cardiologist comes back with you are fine.  I really don't think that the cardiologist would steer you wrong.  They really do have the most education when it comes to what is troubling about the heart.  If he doesn't see your issues as troubling they likely aren't, that doesn't mean you don't have issues, just that they aren't life threatening.  What I would suggest though, since your pcp is concerned, is maybe seek a second opinion from a different cardiologist.  This should give you some peace of mind.  And since you do have a slightly prolonged qt maybe you should just avoid those medicines that might make it longer.  Just better to be safe than sorry so ask your pcp what those medicines are and avoid them.  Take care and keep us posted on how you are doing.  

[michellepetkus]

What I have found is cardiologist are way more calm about heart issues than other health professionals, even the nurses working in their offices.  Most people tend to totally freak out at the slightest thought of a heart issue and the cardiologist comes back with you are fine.  I really don't think that the cardiologist would steer you wrong.  They really do have the most education when it comes to what is troubling about the heart.  If he doesn't see your issues as troubling they likely aren't, that doesn't mean you don't have issues, just that they aren't life threatening.  What I would suggest though, since your pcp is concerned, is maybe seek a second opinion from a different cardiologist.  This should give you some peace of mind.  And since you do have a slightly prolonged qt maybe you should just avoid those medicines that might make it longer.  Just better to be safe than sorry so ask your pcp what those medicines are and avoid them.  Take care and keep us posted on how you are doing.  

[colleenway82]

Thanks. It's not so much that I don't trust the cardiologist, I'm just afraid that I didn't explain the situation to him correctly. It probably is nothing, I just would have felt much better about it if I had insisted he look at the original ecg. But I didn't want to be a pest.

[michellepetkus]

I totally get that.  They always seem so rushed you feel like you are bothering them.  But you actually did ask him to look at it and he refused.  I would take that to mean if the ekg he did on you was clean enough in his opinion your issue is likely not that troubling.  You did have a some prolongation so he did see an issue but doesn't deem it troubling.  But seriously, just go get a second opinion.   Long QT can be serious so I would go a for a second just to be certain.  By any chance were you on cold or allergy medicine before you went to see your pcp and not when you went to see the cardiologist?  These are some of the medicines that might cause it, antibiotics, antidepressants, antihistamines, diuretics, heart medications, cholesterol-lowering drugs, diabetes medications, as well as some antifungal and antipsychotic drugs.  Were you on any of them when you went to the pcp?  Anyhow, they may be drugs you want to avoid if possible.  

[colleenway82]

No medicines, the only difference was I was laying down for the first ecg and sitting up for the other, but I don't know if that would make a difference.
Thanks so much for your help.