Brief Answer:
Full ECG report is needed, Could you upload?

Detailed Answer:
Hi,
Welcome to health care magic,

Abnormal ECG should be found out by reading the ECG leads clinically.

In your case if your 2D echo and TMT (which is known as stress ECG) is normal then I do not think there will be any major cardiac issue.

But I need to have the complete ECG report (with full description of all leads) to give a more precise answer.

It might be a borderline non-cardiac problem, an artifact or a misreading from the machine. Human interpretation is needed.

Looking forward to have the ECG report in.Also let me know if your having diabetes or hypertension (high blood pressure).

Dr.Sandip Kabra

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Brief Answer:
ECG reviewed.

Detailed Answer:
Hello Mr.XXXX,

Thanks for shring your reports.

You have uploaded 3 different ECGs and your Echo report.

1) ECG of 07-Aug-2014 which is almost normal.

2) ECG of 31/08/2015 09:07:24 AM which shows some abnormal waves:

Mild ST elevation in lead III and mild T inversion in V5,V6

3) ECG of 01/09/2015 18:47:53 PM which shows some abnormal waves:

Mild ST elevation in lead III and mild T inversion in lead II,III,aVF and V5,V6.

So,your doctor has further evaluated it by doing 2D-echo and TMT (stress ECG) which are almost normal.

So no need to worry about it till your TMT report is normal.

However,you should check your blood lipid profile also to check the cholesterol level especially.

1) Try to reduce weight if you are obese by doing regular exercises for at least half an hour daily.

2) Avoid oily and junk foods as far as possible.

3) Periodic check of your blood pressure and ECG if possible very monthly or bi-monthly.

4) Continue to take Tab.Aztor (atorvastatin) as directed by your doctor.

5) Have a stress free life,always do yoga and meditation.

Seek help from cardiologist if you have family history of any heart disease.He will guide you further accordingly.

Regards,

Dr.Sandip Kabra

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Brief Answer:
HDL is very low and triglyceride (TAG) is elevated.

Detailed Answer:
Hello Mr.XXXX,

I have gone through all three reports you attached here.

Your HDL is very low and triglyceride (TAG) is elevated while other cholesterols with kidney and liver function tests are completely normal.

The main reason for HDL to be low could be lack of enough muscular exercise.

Initial 20 minutes of walk goes in burning your sugar and then the fat start burning which should happen for another 20 to 25 minutes through a stable, moderate speed of 5 to 6 km/hour and then you will certainly see improvement in the HDL cholesterol.

In general to reduce your Chol/HDL ratio and to increase HDL follow these guidelines:

- Avoid direct sugars
- Avoid fried snacks, bakery items
- Have ample of vegetable salads- at least 1 bowlful cut raw vegetables like cucumber, tomato, carrot and vegetables which you can eat raw.
- Snacks should contain healthy nuts like almonds or walnuts and a few dry fruits but no fruit juices.
- Avoid soft drinks or hard drinks and smoking cessation.
- Simple Chapati and steamed rice or rotis made up of different whole grains should be your staple diet.
- Skimmed milk and milk items made up of skimmed milk are good to check on cholesterol
- Egg white is fine but avoid egg yellow means yolk.
-vitamin B3 (niacin) increases HDL cholesterol.

You should continue with your anti-diabetic and anti-hypertensive medications but I would suggest you to take atorvastatin 10 mg with fenofibrate 200 mg (Atorlip-F) considering your high triglyceride value.

Also,if your TMT was borderline normal (and also 2D-echo) then I do not think about the possibility of mild or missed heart attack.

So,in my opinion you should see DM cardiologist who may prescribe you blood thinner drugs like ecosprin or clopidogrel considering your some abnormal ECG waves and family history of heart disease.

You should repeat ECG after 1 month of this medications to check for the response.Till that time, coronary angiography (CAG) can be withhold or can be done only after cardiologist consultation.

Regards,

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