Firefighter training and EKG situation

[Bruiserman]

Back in July of 06 I had an EKG done.  It came up with a concern with right axis deviation.  My doctor asked me some questions about my work out habits and then felt I was ok to start training at the fire academy.  

Fastfoward to this week.  The fire academy looses all paperwork and I have to go to their doctor for my EKG and I am not approved for training till I get an echo stress test done.  I have never had any problems with the fire ability tests or the extreme physical demands of the training.  I am wondering what would cause this to become a concern and if I should be real worried about the echo stress test.  In fact I tend to outperform many of the candidates, use less air when on the air tanks and during physical training tend to be in the top third of the class in endurance and cardiovascular conditioning.

I am 34 and am in the best shape of my life.  I am completely shocked by this perdicament.  I was told that a heavy workout routine could contribute to this.  I also read somewhere that thyroid medication can contribute.  However I only took thyroid medication from the ages of 10 to around 15.

Am I destined to fail this echo stress because of my LBBB or should I not worry too much right now.  Any insite (if possible)into this would greatly relieve some stress right now. Could my echo stress test come back completely normal with no concerns or am I dreaming.

Thanks in advance for any advise

[EchoTech]

I would not worry too much about the stress test.  I perform these for a living, so I've seen more than a few.  In all lielyhood, if there is any abnormality on the EKG, then you automatically get a stress test to get clearance.  Pilots need to get his kind of clearance too.  If you can hump all the gear around on your back and finish in the top third of the class, then I wouldn't be worried.  I am weak on arrhythmias like LBBB, but I believe that there is a very high probability that you will be a fireman yet.  As far as down the road if this will get worse, I can't even give you an educated guess.  I think there is a tendency for LBBB to develop into something else, but htat is really a wild guess.  I hope I helped you at least with the stress test.

Good night and good luck.

[Schmoomcgoo]

I can't address the issue of how LBBB will effect your future, but maybe I can put you at ease about the stress test.

My husband is a healthy, fit, 44 year old with LBBB, that was discovered much the same way yours was, on an extensive routine physical exam.  He later had an ECG exercise stress test and exercised on the Bruce Protocol for 16 minutes.  (Anyone who reaches 12 minutes is said to have an excellent prognosis and only elite athletes get beyond 18.)  His assessment stated:  "The patient developing exercise induced LBBB should be of no significant consequence in the presence of a normal perfusion scan."

[Bruiserman]

Thank you for the response.  Does the fact that it is an LBBB mean that my echo stress test will show a heart condition of some type or is there a good chance that it will come back without any real issues at this time.  Meaning that I should just continue to monitor the situation but as long as it doesn't get worse my job performance won't suffer.  I don't want to loose everything I have worked for if my heart is really ok.  Can this be a normal condition that I just have to keep in shape and take care of my heart or am I basically looking foward to a more serious condition later down the road reguardless of what I do.  
thanks once again for the responce.
B

[Cleveland Clinic]

Bruiserman,

Thanks for the post.

It's hard when we find an abnormality in an otherwise healthy person. Left Bundle Branch block is a marker for underlying structural heart disease. Overall, people with isolated bundle branch block do display a higher prevalence of underlying cardiac pathology and risk.  This is why, especially in the setting of your job your physician is concerned.

Overall, I would also probably pursue a stress test to screen you for underlying heart disease. I would also follow you over the long term to ensure all other risk factors such as smoking, lipids and blood pressure was well controlled.

The best thing you can do in the long run is to stay as fit as you are.

good luck