Should I have an echocardiogram done?

[ladytraveler13]

Hello:  I recently had an ECG for pre-surgical tests before a facelift.  The results showed  "normal sinus rhythm, rate 74,"   "left anterior fascicular block", "early transition" and  the comment : "consider left atrial enlargement."  My PCP said the block was "insignificant." I had a treadmill test about a year ago after I complained of some pain (not severe) in my  left neck area and left arm and palpitations.  Apparently that test showed the same thing.  Should I be concerned? Should I have other tests? I would be willing to pay for them myself if my HMO wouldn"t authorize them.  Thanks!

[Darcy Green Conaway, MD]

left anterior fascicular block is very common and does not necessarily give you a concerning prognosis. You may have some conduction system disease and this may or may not be related to blockages in the arteries around the heart. I would base concern primarily on your symptoms.

[ladytraveler13]

Thank you for your answer.  I really only have some palpitations at times, sometimes a mild ache in my left upper arm.  I've done several hours of  very vigorous yard work at times with no symptoms, so I'm thinking--esp.because of your answer--I shouldn't worry about this unless I have clearly severe symptoms. I am 60, cholesteral 202, not overweight, smoked for many years, have used 2 mg nicotine lozenges since 7/07, don't drink at all, take Celexa and Wellbutrin, am semi-retired.