Brief Answer:
I would explain as follows:

Detailed Answer:
Hello XXXXXXX

Thank you for asking on HCM!

I carefully reviewed your uploaded ECGs and I am glad to confirm that this pattern of left ventricular repolarization changes (with a slight dynamic regression from the first day to the other day ECG), most likely is due to left ventricular overload.

Left ventricular overload is caused most frequently form hypertension and those changes between the two ECGs may be explained by different LV loading conditions, due to marked blood pressure fluctuations.

This explains why your two ECGs are a bit different from one-another and have caught the attention of ER doctors.

These ECG changes are often seen in the presence of left ventricular hypertrophy, but also in its absence.

I would like to know a recent evidence of your cardiac ultrasound report. Please could you upload it here for a direct review?

Regarding your concern about any cardiac related issues, I would explain that you shouldn't worry about any underlying cardiac ischemia, because both your performed tests (cardiac catheterization and your calcium score on cardiac CT scan) have resulted normal.

So, there is nothing to worry about.

The only advise would be to keep following a healthy lifestyle, to closely monitor your blood pressure on a daily basis for 7-10 days and report those values to your doctor, in order to make the appropriate judgement on the average blood pressure and the decision on the eventual therapy.

I would also advice some lifestyle modifications in order to have a normal blood pressure:

- reduce salt and caffeine intake
- reduce sugar and fat and increase food rich in omega 3 fatty acids (fish, fish oil, olive oil, cashew, walnuts, etc.)
- perform a lot of physical activity (4 km of walking per day are recommended)
- try to lose some pounds if you are overweight
- avoid smoking contacts.

Hope to have been helpful!

In case of further questions, please do not hesitate to ask me again!

Kind regards,

Dr. Iliri

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