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What Does My ECG Test Report Indicate?
Question: My brother had an EKG as part of a routine pre-op for a cervical fusion. The EKG results were done twice, at two different locations. Both readings presented unexpected results of great concern.
He is 45 yrs old, 6' tall, about 190 lbs (looks lean but a bit soft). He is in generally good health but is fairly sedentary. He has a LOT of stress, few positive coping skills, & chronic, severe pain from his neck problems. No hx of alcohol or drug probs, though he does use some pain meds for his neck.
No hx of major illness. No cardiac hx or chest pain, but he IS one of those men who suffers "heartburn" & insists that's all it is. We have some family cardiac hx: a brother & grandma w/tachycardia; me, w/symptomatic PVCs/PACs (controlled w/Coreg); an uncle, age 57, w/severe cardiomyopathy (was told he could drop dead at any moment even w/meds); & another uncle, age 59, on oxygen w/late-stage CHF (a heavy, long-term smoker).
My brother's EKG results were listed as follows: 1. Septal Infarct 2. Atrial Rhythm 3. Abnormal P-axis 4. Incomplete Right Bundle Branch Block 5. Anterior Fascicular Block 6. Possible Inferior Ischemia. This is the list he texted me; unfortunately, I don't have the strip to share.
He was referred for a cardio workup next Wed. Being somewhat medically savvy due to my various health issues, I'll go with him to take notes & ask questions (he just does what they say w/o question!)
In the meantime, I want to know-- are these many, somewhat overlapping findings typical of a particular condition and/or likely indicative of a serious issue? Is it likely indicative of past infarcts? Pleas share any other insights you can offer. I'm a good researcher, but these are overwhelming and confusing results. Thank you.
He is 45 yrs old, 6' tall, about 190 lbs (looks lean but a bit soft). He is in generally good health but is fairly sedentary. He has a LOT of stress, few positive coping skills, & chronic, severe pain from his neck problems. No hx of alcohol or drug probs, though he does use some pain meds for his neck.
No hx of major illness. No cardiac hx or chest pain, but he IS one of those men who suffers "heartburn" & insists that's all it is. We have some family cardiac hx: a brother & grandma w/tachycardia; me, w/symptomatic PVCs/PACs (controlled w/Coreg); an uncle, age 57, w/severe cardiomyopathy (was told he could drop dead at any moment even w/meds); & another uncle, age 59, on oxygen w/late-stage CHF (a heavy, long-term smoker).
My brother's EKG results were listed as follows: 1. Septal Infarct 2. Atrial Rhythm 3. Abnormal P-axis 4. Incomplete Right Bundle Branch Block 5. Anterior Fascicular Block 6. Possible Inferior Ischemia. This is the list he texted me; unfortunately, I don't have the strip to share.
He was referred for a cardio workup next Wed. Being somewhat medically savvy due to my various health issues, I'll go with him to take notes & ask questions (he just does what they say w/o question!)
In the meantime, I want to know-- are these many, somewhat overlapping findings typical of a particular condition and/or likely indicative of a serious issue? Is it likely indicative of past infarcts? Pleas share any other insights you can offer. I'm a good researcher, but these are overwhelming and confusing results. Thank you.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello,
Welcome and thank you for asking on HCM!
I carefully passed through your excellent prescription of all the previous medical histories.
- Regarding your concern, I would like to explain that your brother's ECG pattern probably may be an expression of a cardiomyopathy.
But you shouldn't rely too much on just an ECG machine interpretation (as those are programmed to conclude on some rigid algorithms and not rarely give erroneous interpretations).
- Those ECG findings RBBB + LAFB (incomplete Right Bundle Branch Block and Left Anterior Fascicular Block) are also seen in the settings of a chronic pulmonary disorder. In such case, if nothing else results, a careful investigation of pulmonary function is indicated.
- In addition, a similar ECG pattern may be seen in certain heart positions within the chest (depends on individual body construction). An extreme counterclockwise rotation of the heart may be one factor to consider.
What is best recommended in this situation is a careful physical medical exam, chest X ray film and a cardiac ultrasound (ECHO),which would perfectly delineate or exclude certain cardiomyopathies, any congenital disorder (for example septal defects, etc.), investigating the whole cardiac structure, function and position.
In no clinical symptomatology of heart failure, acute coronary syndrome or ECG evidence of complex arrhythmia are present, then no cardiac contraindication for the programmed surgical procedure exists
In case you provide that ECG strip, please upload it here for a direct review and give a professional opinion.
Meanwhile, I remain at your disposal for any further question, in case of additional uncertainties.
Hope to have been helpful to you!
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello,
Welcome and thank you for asking on HCM!
I carefully passed through your excellent prescription of all the previous medical histories.
- Regarding your concern, I would like to explain that your brother's ECG pattern probably may be an expression of a cardiomyopathy.
But you shouldn't rely too much on just an ECG machine interpretation (as those are programmed to conclude on some rigid algorithms and not rarely give erroneous interpretations).
- Those ECG findings RBBB + LAFB (incomplete Right Bundle Branch Block and Left Anterior Fascicular Block) are also seen in the settings of a chronic pulmonary disorder. In such case, if nothing else results, a careful investigation of pulmonary function is indicated.
- In addition, a similar ECG pattern may be seen in certain heart positions within the chest (depends on individual body construction). An extreme counterclockwise rotation of the heart may be one factor to consider.
What is best recommended in this situation is a careful physical medical exam, chest X ray film and a cardiac ultrasound (ECHO),which would perfectly delineate or exclude certain cardiomyopathies, any congenital disorder (for example septal defects, etc.), investigating the whole cardiac structure, function and position.
In no clinical symptomatology of heart failure, acute coronary syndrome or ECG evidence of complex arrhythmia are present, then no cardiac contraindication for the programmed surgical procedure exists
In case you provide that ECG strip, please upload it here for a direct review and give a professional opinion.
Meanwhile, I remain at your disposal for any further question, in case of additional uncertainties.
Hope to have been helpful to you!
Kind regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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