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EKG on 9 yr old son shows concern of poss enlarged heart
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EKG on 9 yr old son shows concern of poss enlarged heart

My 9 1/2 year old son went for his football physical.  Very routine.  Upon examination, the doctor stated she thought he had an irregular heartbeat and requested an EKG.  The radiologist at the hospital that read the EKG stated that according to that test, there are possible concerns of an enlarged heart.  We are being referred to Nemours Childrens Clinic for some followup testing today.  He has asthma and switched medicine recommended by our pulmonologist.  
My question, is, he had no problems last year.  Could the asthma possibly cause this?  Could the new medicine (Symbicort) cause this?  Or is it possible the test was done incorrectly?

Sincerely,
Scared  momma
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Dear Scared Momma,

Without seeing your son’s ECG or examining him, I cannot say for sure exactly what is going on here.  I can say that ECGs, though being a good test for heart rhythm, are only okay for assessing heart size.  They frequently over call the estimates of heart chamber size.  To be sure, neither his asthma nor his asthma medications likely caused this UNLESS his asthma is so severe and so poorly controlled that he has significant lung and heart disease.  As far as whether the test was done correctly, the placement of the ECG leads on the chest can certainly affect the outcome of the test, and just putting them in the wrong place can lead to incorrect results.  Most likely he will be seen and have a repeat ECG performed.  If the abnormality is found again, or there is something abnormal in his history or examination, he may undergo an echocardiogram, or cardiac ultrasound, which would definitively assess heart size.  However, if everything is normal, there is no reason for this test to be performed.
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