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What Does My ECG Report Indicate?

Posted on Fri, 26 Dec 2014

Question: Hello - I just took an ECG for my mom - she is covered by the same policy number. Her ECG shows abnormal with septal infarct. I am also attaching a copy of the ecg. Please review and provide your opinion.

Answered by Dr. Anantharamakrishnan (8 hours later)

Brief Answer:
Not definite / needs further assessment

Detailed Answer:
Hi friend
Welcome to Health Care Magic

She has Impaired Glucose Tolerance (IGT) / probably Diabetic… Needs Glucose Tolerance Test (GTT) and HbA1c (glycosylated haemoglobin) for further evaluation
Her total cholesterol is high / needs Lipid Profile – HDL (good) and LDL (bad) cholesterol etc…
The ECG is suggestive only - not confirmative – because of absent R wave. There are no other supportive changes… It is a machine interpretation and needs confirmation.
It may or may not be – probably not – an infarct!
There are other reasons – like misplaced lead, Cardiomyopathy etc., which could cause similar pattern
Get her examined by a Cardiologist / one should repeat the ECG and do cardiac markers (enzymes - blood test)
An ECHOcardiogram and stress ECG (TMT - treadmill exercise ECG) are often necessary to rule it out (or rule in)

Good luck
God bless you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anantharamakrishnan (1 hour later)

Thanks for the prompt response doctor. Here are few additional report parameters. Could you please take another look and advice other follow up tests to be conducted.

Answered by Dr. Anantharamakrishnan (4 hours later)

Brief Answer:
NO infarction / Needs drug, life-style changes, more tests & follow up

Detailed Answer:
Hi

STRESS ECG (TMT) is NEGATIVE / it practically excludes Coronary

LAB TESTS:
KIDNEY / LIVER function normal / blood COUNT normal

CHOLESTEROL – very high / LDL is bad cholesterol (LDL = 188)– lower, the better.
In the absence of any other risk factor 100 is ideal for LDL-C. In the presence of ischemia, 70 should be the aim.
     Keep her weight to normal / even a little less
     Quit smoking, if she is a smoker
     Regular EXERCISE – say walking or jogging - 30 minutes a day / at least 5 days in a week.      Healthy FOOD is a must. Avoid saturated fats – coconut oil, palm oil, butter, ghee, full cream milk...Avoid junk foods in particular – French fries have palm oil / Pizza has cheese / XXXXXXX sweets are made in ghee.../ Change to Poly-un-saturated oil – like sun flower oil. / Include Mono-un-saturated oil – Olive oil.
Start drug straight away – this level cannot be controlled by life style changes alone / Statin is the first choice – Atorvastatin 40 mg or any other equivalent statin).
     Repeat the test in 6 weeks.      Cholesterol can still be high, because it is also manufactured in the liver – and that is determined by heredity… may have to step up the dose and/or add one more drug like ezetimibe

SUGAR – HIGH / need GTT and HbA1c, as already suggested
THYROID – High T-4 and low TSH / need further tests and follow up– consult an Endocrinologist

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anantharamakrishnan (6 minutes later)

Thanks so much forthe detailed answer doctor. I would like to consult you in person. Coukd you let me know your consulting location in XXXXXXX (assuming that is your location). Thanks again.

Answered by Dr. Anantharamakrishnan (6 minutes later)

Brief Answer:
See Endocrinologist

Detailed Answer:
Hi

Sorry, I couldn't see her in person
I am XXXXXXX based / but most of the times , out of city or country....
Apollo hospital - where she was seen already - is quite good / keep following up there
And she should be seen by an Endocrinologist (Hormone specialist) now

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anantharamakrishnan (7 minutes later)

Thanks doctor. I will take the following action, please confirm if this is fine.

1-start statin immediately for 6 weeks
2-change diet and exercise changes per your advise
3-repeat the test and then visit an endocrinologist based on the updated results.

One other question - she is taking some ayurvedic medicine for chronic cold, i assume statin drug is not contra for this. Can you please confirm this also.

Thanks much doctor.

Answered by Dr. Anantharamakrishnan (45 minutes later)

Brief Answer:
Restrict to any one system /

Detailed Answer:
Hello

Life style modifications are a MUST – drugs supplement not supplant it
A good dietician could be of real help… because it is life long... We have to change the QUANTITY of food and change the QUALITY too. It is not possible to explain or understand the nuances on a single occasion. One generally needs SEVERAL sessions, to master concepts of calories, nutritional values, biological value, vitamins, minerals and so on.

I would suggest to stick to ONE SYSTEM of Medicine!
Drug interaction cannot be completely excluded, unless the exact composition of the drug is known… Even if it is known, there are likely to be only few studies on such / particular combination.
I will suggest Statin alone … (I am also taking it!)

God bless you

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar