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Precordial Repolarization Disturbance in 5 year old
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Precordial Repolarization Disturbance in 5 year old

Hello There!!
My 5 year old daughter recently started complaining about chest pain. Her pediatrician discovered a heart murmur and sent her to a Pediatric cardiologist. The cardiologist decided to look into it further. She had an ECG yesterday. The reading said: sinus arrythmia, marked precordial repolarization disturbance. What does this mean. Should I be worried?? He has also ordered an Echocardigram but it is not scheduled until a month from now.
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I’m not an EKG expert but I think I can shed some light on these terms.

Sinus arrhythmia is usually completely normal.    It just means that as she takes a breath her heart speeds up a bit.  When she exhales her heart slows down.  Nature programmed us this way to enhance gas exchange as we breathe.  

I haven’t heard of precordial repolarization disturbance before and surprisingly I’m not seeing much from googling the term.  What I know is, the precordial part of the body is the area located over the heart and lower chest.   What I think the marked precordial repolarization disturbance means is:

1.  The disturbance was seen in the leads on your child’s precordial region of the body which means it was over the heart, lower chest area.  This is always noted in EKGs because the issues they see can happen in any of the 12 leads placed around the body.  Important diagnostic info can be gleamed by knowing which lead the issue is seen.  For your child it was seen on the chest leads.

2.  Repolarization is the part of the heart beat where the muscle is recovering from the last contraction.  Think if it as the muscle getting its battery ready to fire again.  There are two major parts of the heart muscle.  One is the top part, or the atrium, and bottom is called the ventricles.  Because the atria has much less muscle mass you can’t really see the repolarization wave from the atria.  You can only really detect the wave in the ventricles.  The repolarization wave in the ventricles is called the “T” wave.  So what I’m thinking they saw was a disturbance in your child’s T wave.  Disturbance is a very generic term to use here, it can be all sort of things, like something called “t wave inversion”.

So, given the murmur plus the repolarization disturbance seen in the chest leads more tests would be indicated to rule out structural or valve issues which would be the echo to see the structure of the heart and see how the valves are working.

Hopefully everything is fine and the echo is uneventful.  Keep us posted if you need any help.
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