Pediatric Heart Expert Forum
Irregular ekg
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Irregular ekg

My daughter is 6.  During her last well check, her primary doctor heard a heart murmur.  He believed it was innocent but due to my family's history of heart disease, I requested further tests to be performed.  The doctor ordered an ekg test and an x-ray.  The x-ray came back normal but we got a call about an irregular ekg result.  We weren't given any additional information other than an cardiologist will be calling us for further tests.  I'm scared out of my mind.  What could be causing the irregular ekg?  And does that mean the heart murmur is not innocent after all?
Thanks
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773637_tn?1327450515
Dear Ssliu,

Unfortunately, without seeing the ECG, I cannot tell you what exactly is irregular about it.  It could be a normal variant, or something truly abnormal.  The ECG typically is printed out from a machine that has computerized algorithms that attempt to electronically “read” the ECG and give a preliminary result.  Sometimes, this interpretation is correct; sometimes, it either misses things or over-calls things that are not really there.  Because of this, an ECG should be officially read by someone who understands how to correctly interpret the study results.  These results are often sent back to the requesting provider for interpretation in light of the rest of the clinical findings.  If there is any specific concern, the patient can be referred for further evaluation to a specialist, such as a pediatric cardiologist in your daughter’s case.  At times, primary care providers will see the preliminary results from the computer’s interpretation and send the patient for evaluation without being able to give an official interpretation.  In this case, patients can often be normal, as the interpretation is an over-call.  However, there are times that the computer interpretation is correct and that “innocent” murmur is actually a murmur associated with a structural defect.

At this point, what I can tell you is that, since your daughter is 6 years old and, likely, asymptomatic, there is probably nothing immediately life-threatening going on here.  Beyond that, you will have to see what either your primary care provider or the cardiologist has to say about the interpretation of the ECG in light of the examination findings.
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