What Do The Following ECG Results Indicate?

Brief Answer:
I would explain as follows:

Detailed Answer:
Dear XXXXXXX

Welcome back on HCM!

I carefully reviewed all your uploaded ECG and would explain that the main findings in these ECG are:

- the presence of incomplete right bundle branch block (iRBBB)
- left anterior fascicular block (LAFB)
- a borderline PR interval duration (up to 90 msec)
- prominent P wave in leads DII, DIII, aVF
- presence of q waves in septal leads.

Now let me explain the potential reasons for the above ECG findings:

1- The presence of iRBBB and LAFB coupled with borderline PR and q waves in septal leads may be an expression of cardiac conductance system abnormalities.

2- The prominent P wave and iRBBB may be related to a chronic pulmonary disorder.

3- The presence of septal q waves may be explained by:
- septal fascicular block,
- chronic pulmonary disorder
- inter-ventricular septal hypertrophy.

Coming to this point, as the ECG is a test that may help in the differential diagnosis of several health disorders, but should be coupled with additional medical tests in order to arrive to an exact diagnosis, I would recommend performing the following tests:

a- a trans-thoracic cardiac ultrasound (echo), for investigating the cardiac structure and function
b- chest X ray study, pulmonary function tests, arterial blood gas analysis, to rule in/out any possible pulmonary dysfunction
c- a 24-48 hours ambulatory ECG monitoring (Holter) to investigate for any possible hidden cardiac conductance system dysfunction (sick sinus syndrome).

I recommend discussing with your attending doctor on the above mentioned issues.

Hope to have clarified your uncertainties!

And please remember to follow my tips regarding Roemheld syndrome, in order to avoid possible exacerbation of this disorder.

I remain at your disposal for any further questions!

Wishing you a pleasant weekend!

Regards,

Dr. Iliri

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Brief Answer:
My answer as follows:

Detailed Answer:
Dear XXXXXXX

I am glad that my tips are helping you go through this situation!

I carefully passed through your uploaded referral letter, and would explain that it seems to be a normal overview of your clinical situation.

You should discuss with the new doctor on the above issues and also about Roemheld Syndrome as a possible cause of all your symptoms.

Regarding the radio program, you can follow it regularly as you find it helpful!

But, I would also explain that every case is different and the problem is more complex considering the thyroid problems and sleep apnea.

So, every individual is different and things on the internet can be sometimes misleading, especially depending on the individual characteristics (age, gender, lifestyle, comorbidities, etc.).

I would be happy to be your personal online cardiologist.

You can ask me directly at any time on my personal link:

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765

Regards,

Dr. Iliri

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