Pediatric Heart Expert Forum
My 3 yr old son's EKG
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My 3 yr old son's EKG

My sons Dr heard a murmur when he was about 6- 8 mos old. they said it should fix itself. well just last wk at his 3 yr physical a different Dr heard it also and refered us to a ped Cardiologist. we went today and he said the EKG was borderline and the left side of his heart seemed to be working harder than the right side so he decided to do an Ecko in the office and said the Ecko was normal and it was just a harmless innocent murmur that some kids have.
But I don't understand why the EKG was "borderline" and the L side was working harder than the R? Should I get a second opinion?
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Dear Krys,

Without evaluating these studies or your son, it is difficult for me to say exactly what is going on here.  However, what I would say is that possibly the ECG suggested that the left ventricle (the pumping chamber on the left) showed hypertrophy, or thickening of the heart muscle.  This is often what is meant by “working harder”.  However, the diagnosis of left ventricular hypertrophy (LVH) by ECG is not straightforward.  In fact, some cardiologists like to see at least two ECG criteria demonstrated to truly call LVH, with only one criterion labeled as borderline LVH.  That said, ECG’s are used as a screening test, and can have a lot of false positive findings, ESPECIALLY with LVH.  Thus, the echocardiogram, or cardiac ultrasound, is the definitely test to demonstrate if there is anything wrong.  In your son’s case, the echo was normal, likely indicating that there was no LVH and an otherwise structurally normal heart.  Therefore, we typically say that the murmur is an innocent, or normal, murmur.  If you feel that this explanation is similar to what you heard from your cardiologist, then a second opinion is probably not necessary.
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