What Do The Following EKG Reports Indicate?

Posted on Thu, 14 May 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 14 May 2015 Answered on

Wed, 3 Jun 2015 Last reviewed on

Question : Hi, I recently pulled my last 2 EKGs after my brother had chest pains and I needed to get his for a cardiologist visit...we have same doctor. For mine both list the the below with slight differences...I know you can't diagnose, but doc never even mentioned any of this. His was abnormal as well but with sinus bradycardia prolonged Qt interval and poor r wave progression. He has Down syndrome.

Does mine warrant a visit to cardiologist warranted as well. Both are labelled abnormal EKGs. My history is only hypothyroid...well controlled....but regardless of that I am always wiped out and fatigued.

Sinus rhythm normal
rSr' (v1) - probable normal variant
Possible anterior infarct - age undetermined
Lateral T wave changes are non specific

And

Sinus rhythm normal
rSr' (v1) - probable normal variant
Possible anterior infarct - age undetermined
Low QRS voltages in percordial leads

Answered by Dr. Sukhvinder Singh (3 hours later)

Brief Answer:
Need ECG graphs and details.

Detailed Answer:
Dear Madam
I understand your concern but it would be best if you can upload the actual ECG graphs on right top corner of this page as an attachment. ECGs are best interpreted in light of clinical circumstances by actually looking at them. Beside the graphs I would also like to know
1. Why these ECGs were done?
2. If you have any history of chest heaviness/ chest pain on exertion?
3. If you smoke or you are taking medicines for high blood pressure or diabetes?
4. How much exercise you can do without being obviously breathless? like number of flight of stairs you can use or number of miles you can walk at normal speed.
Waiting for your details.
Sincerely
Sukhvinder

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Sukhvinder Singh (7 hours later)

ECGs were done as part of a normal physicals. But had been seeing doc for severe fatigue. I am a former smoker. History of 25+ years. pack a day. I have been in ER previously for chest pains and have had chest pains on and off for a few years. I previously have had severe shortness of breath after walking up 1 flight of stairs and when laying down..but has been better. Legs feel heavy all the time. I am hypothyroid with Hashimotos but all values are normal. Take 112 levothyroxine. no other meds.

Answered by Dr. Sukhvinder Singh (3 hours later)

Brief Answer:
please see details

Detailed Answer:
Dear Madam
1. The rSr' pattern in lead V1 is possibly a normal variant. There are no lateral wall T wave changes of significance. There is Poor R wave progression in precordial leads but this can have many reasons beside anterior wall infarction. Most likely reasons in practice are poor positioning of leads, normal variants, rotated heart orientation and then anterior wall infarction (a kind of heart attack).
2. The ECG changes are nearly same in two ECGs taken one and a half year apart. There are no other changes (T or ST) suggestive of ischemic heart disease. All these taken together make the chances of an old heart attack less likely. However in view of history of smoking and shortness of breath on exertion, It would be prudent to consult a cardiologist/ get an ECHO (cardiac ultrasound) done. This will essentially rule out a major heart attack in past.
Sincerely
Sukhvinder

Above answer was peer-reviewed by : Dr. Vaishalee Punj