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Should A 2D Echo Be Done For Further Evaluation While Having Hypothyroidism And With Incomplete RBBB?
Question: Dear Sir, Please Suggest in a ECG, a female patient with hypothyroidism and with incomplete RBBB. can we suggest 2D echo for further evaluation.
XXXXXXX 66/F.
Brief Answer:
Better go for a TMT
Detailed Answer:
Hi,
Welcome.
This is Dr Sameer, cardiologist.
RBBB is normal in 70% peoples and does not need any special evaluation until their is any symptom.
One other thing I saw in the reporting was ST depression in lead 3, aVF(which denotes inferior wall).
You can go for a Tread mill test to rule out any possible ischemia. Echo can also be done but I expect that to be normal.
If you have any more questions, I'll be happy to help.
Thanks & take care
Better go for a TMT
Detailed Answer:
Hi,
Welcome.
This is Dr Sameer, cardiologist.
RBBB is normal in 70% peoples and does not need any special evaluation until their is any symptom.
One other thing I saw in the reporting was ST depression in lead 3, aVF(which denotes inferior wall).
You can go for a Tread mill test to rule out any possible ischemia. Echo can also be done but I expect that to be normal.
If you have any more questions, I'll be happy to help.
Thanks & take care
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Dear Sir,
wrong image was attached please find correct image of ECG and guide further.
wrong image was attached please find correct image of ECG and guide further.
Brief Answer:
Need further evaluation
Detailed Answer:
Hi,
Welcome back.
Yes definitely their is ST depression with T inversion in inferior and lateral leads which could be ischaemic changes.
I suggest to get a stress echo (which is better than TMT) done to rule out above. Only echo won't reveal anything. Stress echo is a better test with higher sensitivity to rule out ischemia.
Other non invasive test which can be done is CT Coronary Angiography. Both are good, CT Angio is expensive but with higher sensitivity and higher radiation exposure than Stress echo.
So it depends on patients preference. You can choose any one.
If it would have been my patient and the patient had symptoms of angina I would have directly gone for angiography.
Thanks and take care.
Need further evaluation
Detailed Answer:
Hi,
Welcome back.
Yes definitely their is ST depression with T inversion in inferior and lateral leads which could be ischaemic changes.
I suggest to get a stress echo (which is better than TMT) done to rule out above. Only echo won't reveal anything. Stress echo is a better test with higher sensitivity to rule out ischemia.
Other non invasive test which can be done is CT Coronary Angiography. Both are good, CT Angio is expensive but with higher sensitivity and higher radiation exposure than Stress echo.
So it depends on patients preference. You can choose any one.
If it would have been my patient and the patient had symptoms of angina I would have directly gone for angiography.
Thanks and take care.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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