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What Casues Sinus Bradycardia?
Question: HI Dr,
Just had 3rd EKG in two weeks in prep for surgery slated for 2 weeks. Should I be concerned?
65 yr old female, 99 lbs. train at gym with weights 25 yrs 4x/week, don't drink eat uber healthy yet EKG
reports normal sinus rhythm (today's test) and anteroseptal infarction, probably old.
Last week's EKG said Sinus Bradycardia / suspect anterior infarcti
Now what?
Thanks in advance
Just had 3rd EKG in two weeks in prep for surgery slated for 2 weeks. Should I be concerned?
65 yr old female, 99 lbs. train at gym with weights 25 yrs 4x/week, don't drink eat uber healthy yet EKG
reports normal sinus rhythm (today's test) and anteroseptal infarction, probably old.
Last week's EKG said Sinus Bradycardia / suspect anterior infarcti
Now what?
Thanks in advance
Brief Answer:
2D ECHO, STRESS TEST, THALLIUM SCAN
Detailed Answer:
Dear XXXX
Greetings from health care magic!!! I am Dr Thakker and shall be answering your question.
first and foremost, I must congratulate you for having regular exercise for last 25 yrs and following a healthy diet.
I wish to know if you have a history of hypertension/ diabetes / heart disease in the family?
Can you please upload todays EKG as well?
I have been through your labs, x -ray and 2 EKG tracings.
There is a suspicious Q wave in lead V2 which can possibly be due to an old MI. However we need to perform a 2D ECHO of the heart as a next step to see if there is a scar left behind by that old MI. Stress test will also be helpful to rule out inducible ischemia. Thallium scan will tell us if there is a scar. This appears as a cold spot on the thallium scan.
With regards to bradycardia, this can be physiological. You can have an athletic heart, wherein the native heart rate is low. This is common in athletes. We can perform a thyroid test to make sure it was not causing the bradycardia. Your serum potassium levels need to be repeated as they maybe spuriously high. Low levels can cause bradycardia.
Your x ray shows COPD. However it has not lead to any heart complication or MI.
I hope this helps you out. If you have any more questions, please do not hesitate to write back to me.
Yours sincerely,
Dr Thakker.
2D ECHO, STRESS TEST, THALLIUM SCAN
Detailed Answer:
Dear XXXX
Greetings from health care magic!!! I am Dr Thakker and shall be answering your question.
first and foremost, I must congratulate you for having regular exercise for last 25 yrs and following a healthy diet.
I wish to know if you have a history of hypertension/ diabetes / heart disease in the family?
Can you please upload todays EKG as well?
I have been through your labs, x -ray and 2 EKG tracings.
There is a suspicious Q wave in lead V2 which can possibly be due to an old MI. However we need to perform a 2D ECHO of the heart as a next step to see if there is a scar left behind by that old MI. Stress test will also be helpful to rule out inducible ischemia. Thallium scan will tell us if there is a scar. This appears as a cold spot on the thallium scan.
With regards to bradycardia, this can be physiological. You can have an athletic heart, wherein the native heart rate is low. This is common in athletes. We can perform a thyroid test to make sure it was not causing the bradycardia. Your serum potassium levels need to be repeated as they maybe spuriously high. Low levels can cause bradycardia.
Your x ray shows COPD. However it has not lead to any heart complication or MI.
I hope this helps you out. If you have any more questions, please do not hesitate to write back to me.
Yours sincerely,
Dr Thakker.
Above answer was peer-reviewed by :
Dr. Yogesh D
Dear Dr Thakker,
First thank you very much for your detailed response. I neglected to add that I'm XXXXXXX however the labs were all done in (I've just moved to---Ant) Antigua and St Lucia---not the best healthcare in the Caribbean. No family nearby or friends so your attention is mentally helpful.
To answer your question...re history of hypertension/ diabetes / heart disease in the family? None whatsoever, nor any cancers. I did send you today's EKG which was done in My (new) Doc's office whereas the other was done directly at a lab. On today's EKG I named it with today's date-June 12-2014 This reading says normal reading for sinus rhythms ( as opposed to last week's results)
In Dec 2013 near Xmas I had cosmetic surgery 'around the world' when 5" of loose flesh was cut away from my mid section all around and I was pulled up like a pair of trousers. No problems at all. The same surgeon (in XXXXXXX GA) is scheduled to replace 32 yr old implants (one is leaking) on 25th XXXXXXX but obviously if there is a problem, the anesthesiologist will not allow surgery--so all this is timely.
As far as my platelets clumping...report Nov 2014 said same but count was good. This time the labs said count 28-and when I repeated 3 days later, count 21--thus the bone marrow biopsy yesterday. Specimens were sent to USA and I will have results in a week. But, I have no symptoms at all and feel wonderful always..not even any joint pain--never fatigued, no blood or discoloration in urine and no bruising etc. Nothing makes sense.
Two months ago before i moved, my trainer and I augmented weight training with running 2000 steps twice a week. He is 30 and was as winded as I. I also swim a mile a few times a week.
I truly value you interest and response.
Best regards,
XXXX
First thank you very much for your detailed response. I neglected to add that I'm XXXXXXX however the labs were all done in (I've just moved to---Ant) Antigua and St Lucia---not the best healthcare in the Caribbean. No family nearby or friends so your attention is mentally helpful.
To answer your question...re history of hypertension/ diabetes / heart disease in the family? None whatsoever, nor any cancers. I did send you today's EKG which was done in My (new) Doc's office whereas the other was done directly at a lab. On today's EKG I named it with today's date-June 12-2014 This reading says normal reading for sinus rhythms ( as opposed to last week's results)
In Dec 2013 near Xmas I had cosmetic surgery 'around the world' when 5" of loose flesh was cut away from my mid section all around and I was pulled up like a pair of trousers. No problems at all. The same surgeon (in XXXXXXX GA) is scheduled to replace 32 yr old implants (one is leaking) on 25th XXXXXXX but obviously if there is a problem, the anesthesiologist will not allow surgery--so all this is timely.
As far as my platelets clumping...report Nov 2014 said same but count was good. This time the labs said count 28-and when I repeated 3 days later, count 21--thus the bone marrow biopsy yesterday. Specimens were sent to USA and I will have results in a week. But, I have no symptoms at all and feel wonderful always..not even any joint pain--never fatigued, no blood or discoloration in urine and no bruising etc. Nothing makes sense.
Two months ago before i moved, my trainer and I augmented weight training with running 2000 steps twice a week. He is 30 and was as winded as I. I also swim a mile a few times a week.
I truly value you interest and response.
Best regards,
XXXX
Brief Answer:
please read the response
Detailed Answer:
Dear XXXX
Thank you for your response and sharing your past medical history in detail.
My recommendations for you are the same:
Thyroid levels, potassium levels, 2 D ECHO, thallium scan.
Your bradycardia could be from an athletic heart. However the above investigations will help us to clear things out.
I have read the old urine reports attached. They don't have any role with your current EKG findings.
I hope this helps you out. If you have any more questions, please do not hesitate to write back to me.
Yours sincerely,
Dr Thakker.
please read the response
Detailed Answer:
Dear XXXX
Thank you for your response and sharing your past medical history in detail.
My recommendations for you are the same:
Thyroid levels, potassium levels, 2 D ECHO, thallium scan.
Your bradycardia could be from an athletic heart. However the above investigations will help us to clear things out.
I have read the old urine reports attached. They don't have any role with your current EKG findings.
I hope this helps you out. If you have any more questions, please do not hesitate to write back to me.
Yours sincerely,
Dr Thakker.
Above answer was peer-reviewed by :
Dr. Prasad
You're up early, Doctor.
Thank you for writing I will follow your recommendation.
Have a wonderful day and hopefully I can clear myself of these demons.
Kind regards,
XXXX
Thank you for writing I will follow your recommendation.
Have a wonderful day and hopefully I can clear myself of these demons.
Kind regards,
XXXX
Brief Answer:
thank you
Detailed Answer:
Dear XXXX
Thank you for your reply. You too have a great day ahead.
Dr Thakker.
thank you
Detailed Answer:
Dear XXXX
Thank you for your reply. You too have a great day ahead.
Dr Thakker.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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