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Suggest Treatment For Acute Heart Attack
Question: My mom is 64 yrs old and everytime she does a routine EKG , it comes as a bundle block ekg. Her herat doctor did sonogram, and other test which is ok. Currently she has high blood pressure so basically they are waiting to see once the pressure gets normal they will do stress test on her.
Recently she was in ER and the visiting cardiologist said that there is nothing really to do with this kind of abnormal ekg and leave it like that. I am not happy with his answer. My question is will be the result of any artery blockage? if so what is the procedure to perform? Angioplast or Catharization? She never had a heart attack and her sonogram of heart and neck are normal.
Should i also write the XXXXXXX names of her medications? Please advice
Thanks
Mr XXXXXXX
New York
USA
Recently she was in ER and the visiting cardiologist said that there is nothing really to do with this kind of abnormal ekg and leave it like that. I am not happy with his answer. My question is will be the result of any artery blockage? if so what is the procedure to perform? Angioplast or Catharization? She never had a heart attack and her sonogram of heart and neck are normal.
Should i also write the XXXXXXX names of her medications? Please advice
Thanks
Mr XXXXXXX
New York
USA
Brief Answer:
It doesn't seem to be an acute heart attack.
Detailed Answer:
Hello! Thank you for asking on HCM!
I understand your concern and would like to explain that bundle branch block is not an infrequent finding in adults and aged people. It may be right or left bundle branch block (RBBB or LBBB). It may be of ischemic or non-ischemic origin. I don't know which of the two was present in your mom's case, but I would say that RBBB pattern doesn't mask the ECG signs of myocardial ischemia, as LBBB do. So if ischemia is present it can be judged by resting ECG in the presence of RBBB, it is almost very difficult to do the same when we have to do with LBBB.
(a) If BBB is not new and has been present for a long time, and no clinical symptoms of chest pain (or its equivalent such as dyspnea in diabetes people) is present, coupled with normal cardiac ultrasound findings (no ischemic LV kinetics abnormalities) and normal lab blood tests (cardiac enzymes like Troponin and CK-MB), then I would like to relief your anxiety, and say don't worry. In this case there is no evidence of any acute heart attacks. You have just to control high blood pressure and other coronary risk factors, and eventually perform a cardiac stress test.
(b) From the other side, if your mom has experienced chest pain (or its equivalent) and we have a new BBB (for example LBBB), and some evidence from lab tests are abnormal, then a prompt clinical invetigastion regarding coronary artery exploration would be necessary. If chest pain is coupled with new BBB (LBBB or RBBB) and abnormal high cardiac enzymes, then coronary angiography with eventual angioplasty should be performed.
From what you refer, it doesn't seem your mother is suffering an acute heart attack, so don't worry! Just you have to be alert and clarify this issue. Perform cardiac stress test that your doctor adviced.
If you have ECG recordings, ECHO and other performed blood tests, please upload to give a more detailed opinion.
Hope to have been helpful to you. Greetings! Dr. Iliri
It doesn't seem to be an acute heart attack.
Detailed Answer:
Hello! Thank you for asking on HCM!
I understand your concern and would like to explain that bundle branch block is not an infrequent finding in adults and aged people. It may be right or left bundle branch block (RBBB or LBBB). It may be of ischemic or non-ischemic origin. I don't know which of the two was present in your mom's case, but I would say that RBBB pattern doesn't mask the ECG signs of myocardial ischemia, as LBBB do. So if ischemia is present it can be judged by resting ECG in the presence of RBBB, it is almost very difficult to do the same when we have to do with LBBB.
(a) If BBB is not new and has been present for a long time, and no clinical symptoms of chest pain (or its equivalent such as dyspnea in diabetes people) is present, coupled with normal cardiac ultrasound findings (no ischemic LV kinetics abnormalities) and normal lab blood tests (cardiac enzymes like Troponin and CK-MB), then I would like to relief your anxiety, and say don't worry. In this case there is no evidence of any acute heart attacks. You have just to control high blood pressure and other coronary risk factors, and eventually perform a cardiac stress test.
(b) From the other side, if your mom has experienced chest pain (or its equivalent) and we have a new BBB (for example LBBB), and some evidence from lab tests are abnormal, then a prompt clinical invetigastion regarding coronary artery exploration would be necessary. If chest pain is coupled with new BBB (LBBB or RBBB) and abnormal high cardiac enzymes, then coronary angiography with eventual angioplasty should be performed.
From what you refer, it doesn't seem your mother is suffering an acute heart attack, so don't worry! Just you have to be alert and clarify this issue. Perform cardiac stress test that your doctor adviced.
If you have ECG recordings, ECHO and other performed blood tests, please upload to give a more detailed opinion.
Hope to have been helpful to you. Greetings! Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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