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What Does This ECG Report Indicate?
Question: I have a history of Angioplasty done on XXXXXXX 2014. I do regular annual checkup . kindly refer to my ECG report of 2014 and 2015 and let me know if there is any change as such. Regards XXXX
Brief Answer:
please get your echo and stress test
Detailed Answer:
Hello Mr XXXXXXX Welcome to HCM.
I am Dr.Rajesh Teli , MD.
I have gone through your query.Thanks for using HCM.
I would like to know your exact detail of angiogram and the report of angioplasty .
Comparison of ECGs may not give any new information .you should get echocardiogram and if your LVEF is satisfactory you should undergo Exercise stress test .
I request you to attach actual ECGs and angio reports to guide you properly
My best wishes
Dr.Teli.
please get your echo and stress test
Detailed Answer:
Hello Mr XXXXXXX Welcome to HCM.
I am Dr.Rajesh Teli , MD.
I have gone through your query.Thanks for using HCM.
I would like to know your exact detail of angiogram and the report of angioplasty .
Comparison of ECGs may not give any new information .you should get echocardiogram and if your LVEF is satisfactory you should undergo Exercise stress test .
I request you to attach actual ECGs and angio reports to guide you properly
My best wishes
Dr.Teli.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
I have attached both the reports
Brief Answer:
unable to find attachment
Detailed Answer:
Hello,
I am sorry to inform you that I am unable to find attachment of reports .please do the needful.
Thanks
Dr.Teli.
unable to find attachment
Detailed Answer:
Hello,
I am sorry to inform you that I am unable to find attachment of reports .please do the needful.
Thanks
Dr.Teli.
Above answer was peer-reviewed by :
Dr. Raju A.T
sorry I have attached the files
Brief Answer:
Both ECG are more or less same
Detailed Answer:
Hello Mr. XXXX,
As I had mentioned earlier comparison of Both ECGs does not give any vital information at this stage except old heart attack..Both are showing Old anteroseptal MI.
I can predict that you must have blocked Left anterior descending artery(LAD) leading to heart attack.You must have undergone PTCA with stent to LAD.
I suggest you to get an Echocardiography and cardiac stress test done,this will give us information on patency of stent and any possible new blocks in other arteries,
My best wishes
Dr.Teli.
Both ECG are more or less same
Detailed Answer:
Hello Mr. XXXX,
As I had mentioned earlier comparison of Both ECGs does not give any vital information at this stage except old heart attack..Both are showing Old anteroseptal MI.
I can predict that you must have blocked Left anterior descending artery(LAD) leading to heart attack.You must have undergone PTCA with stent to LAD.
I suggest you to get an Echocardiography and cardiac stress test done,this will give us information on patency of stent and any possible new blocks in other arteries,
My best wishes
Dr.Teli.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear Dr you are right. I have been through angioplasty last year in the month of XXXXXXX 2 drug eluted stents implanted in LAD and LCX. I am doing annual checkup every Dec thought of sharing last 2 year report if ECG to check the comparison. .all other blood reports are alright with in limit. elevated level of triglycerides and Colestrol was reason for blockage. do you think I should go for CT cardiac to check sent postining as it is more then 1.5 year
Brief Answer:
no need for cardiac CT
Detailed Answer:
Hello,.
Again I am repeating you should get exercise stress testing done.Normal test not only confirms properly positioned stents but also rules our new blocks at other sites.
My best wishes.Your LDL must remain below 70,cholesterol below 150 and Triglycerides below 200.
My best wishes
Dr.Teli.
no need for cardiac CT
Detailed Answer:
Hello,.
Again I am repeating you should get exercise stress testing done.Normal test not only confirms properly positioned stents but also rules our new blocks at other sites.
My best wishes.Your LDL must remain below 70,cholesterol below 150 and Triglycerides below 200.
My best wishes
Dr.Teli.
Above answer was peer-reviewed by :
Dr. Yogesh D
Great thanks I am going for 2D eco and CT angiogram. hope these tests would help
Brief Answer:
you may get it done
Detailed Answer:
Hello,
I do not understand why are you avoiding exercise stress test.if your stress test is normal.you can avoid exposure to radiation .CT coronary angio provides dose of radiation worth 100 plain x rays.so better to avoid.If CT angio is abnormal by chance (less likely ) then you will need routine angio again .so better you go for exercise stress test .If normal no further work up and if abnormal go for conventional angio.This is my suggestion ,
My best wishes
Dr.Teli.
you may get it done
Detailed Answer:
Hello,
I do not understand why are you avoiding exercise stress test.if your stress test is normal.you can avoid exposure to radiation .CT coronary angio provides dose of radiation worth 100 plain x rays.so better to avoid.If CT angio is abnormal by chance (less likely ) then you will need routine angio again .so better you go for exercise stress test .If normal no further work up and if abnormal go for conventional angio.This is my suggestion ,
My best wishes
Dr.Teli.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
I was unable to share complete history through app hence I have send it through mail to customer care team and adviced them to share with you. Thanks XXXX
Dear Dr, Every year I go for regular health check up in the month Dec I have been following this routine since 2010 . my heridtery profile is of hypercolestromia one thing which I avoided in past is medication to treat colestrol and lifestyle cages in term of eating habits though I was regular to exercise . In 2013 stress test I was normal however with in 6 months I got attack. last year my stress test was normal in this year there is an impression of mild inferior wall ischaemia. at 4th stage of inclination dr adviced me to run in few seconds my heart rate shoot up and suddenly came down she adviced me to stop. now I have been further adviced to go for CT Angiogram and 2D Echo though dr informed it is very mild and since all my other reports are perfectly alright and stents are more more then an year old, Further I Am leading a very healthy lifestyle it is very unlikely that you would get something but with reports you will be relaxed. Now Dr I am seriously against doing any such intervention which cause further harm do body as I know what lifestyle I am leaving today .completely on medication Ecosprin 150, Prax 20, metxl 25 and consivas 20 mg in addtion to this I have stopped smoking, drinking, oil and junk food only on oil less food and fruits plus dry fruits in moderate quantity. lifestyle I have been into running and exercising now I can run upto 10 Km and more in less then 60 minute withoht much exertion. I read stress test are not trustworthy tool completely relay on. I am feeling perfectly alright no sign of angina the only factor I would like to share I was not taking complete sleep before stress test those 20 days were little stressed in term of sleep. I suspect timing of test could be reason for heart rate shoot up . Thus is my profile . kindly advice which test is more appropriate at this stage.Thsnks
Dear Dr, Every year I go for regular health check up in the month Dec I have been following this routine since 2010 . my heridtery profile is of hypercolestromia one thing which I avoided in past is medication to treat colestrol and lifestyle cages in term of eating habits though I was regular to exercise . In 2013 stress test I was normal however with in 6 months I got attack. last year my stress test was normal in this year there is an impression of mild inferior wall ischaemia. at 4th stage of inclination dr adviced me to run in few seconds my heart rate shoot up and suddenly came down she adviced me to stop. now I have been further adviced to go for CT Angiogram and 2D Echo though dr informed it is very mild and since all my other reports are perfectly alright and stents are more more then an year old, Further I Am leading a very healthy lifestyle it is very unlikely that you would get something but with reports you will be relaxed. Now Dr I am seriously against doing any such intervention which cause further harm do body as I know what lifestyle I am leaving today .completely on medication Ecosprin 150, Prax 20, metxl 25 and consivas 20 mg in addtion to this I have stopped smoking, drinking, oil and junk food only on oil less food and fruits plus dry fruits in moderate quantity. lifestyle I have been into running and exercising now I can run upto 10 Km and more in less then 60 minute withoht much exertion. I read stress test are not trustworthy tool completely relay on. I am feeling perfectly alright no sign of angina the only factor I would like to share I was not taking complete sleep before stress test those 20 days were little stressed in term of sleep. I suspect timing of test could be reason for heart rate shoot up . Thus is my profile . kindly advice which test is more appropriate at this stage.Thsnks
Brief Answer:
please attach your tracings of stress test
Detailed Answer:
Hello Mr. XXXX,
First of all thanks for giving me complete history.I myself was not satisfied with guidance I gave you due to lack of complete information.
I would like you to consider following details.
1.Life style is playing very vital role in your case.You have now started consivas 20 mg to control cholesterol and are indeed following healthy life style .So now your chances of fresh blockage and stent blocks are negligible.Keep up this life style an monitor cholesterol 6 monthly with target to lower LDL below 70,Cholesterol below 150,HDL above 35 and Triglycerides below 200.
2.No investigation of medical science is 100% accurate .You have rightly thought so about Exercise treadmill test.It is has specificity of 70%.But the interpretation of test is very important.we usually consider following aspects while analysing report 1.whether patient has chest pain or any unusual symptoms? 2.What is the deterioration of ECG in terms of ST depression and at what stage.3.How rapidly ST depression reverts to normal.4.what was BP response and what was the reason to terminate the test.
I would like to know these details about your TMT,If you could scan and attach all tracings of TMT I would be more confident to guide you.My primary suggestion is to wait for CT angio.Please get 2D echo done and send me reports,
My best wishes
Dr.Teli.
please attach your tracings of stress test
Detailed Answer:
Hello Mr. XXXX,
First of all thanks for giving me complete history.I myself was not satisfied with guidance I gave you due to lack of complete information.
I would like you to consider following details.
1.Life style is playing very vital role in your case.You have now started consivas 20 mg to control cholesterol and are indeed following healthy life style .So now your chances of fresh blockage and stent blocks are negligible.Keep up this life style an monitor cholesterol 6 monthly with target to lower LDL below 70,Cholesterol below 150,HDL above 35 and Triglycerides below 200.
2.No investigation of medical science is 100% accurate .You have rightly thought so about Exercise treadmill test.It is has specificity of 70%.But the interpretation of test is very important.we usually consider following aspects while analysing report 1.whether patient has chest pain or any unusual symptoms? 2.What is the deterioration of ECG in terms of ST depression and at what stage.3.How rapidly ST depression reverts to normal.4.what was BP response and what was the reason to terminate the test.
I would like to know these details about your TMT,If you could scan and attach all tracings of TMT I would be more confident to guide you.My primary suggestion is to wait for CT angio.Please get 2D echo done and send me reports,
My best wishes
Dr.Teli.
Above answer was peer-reviewed by :
Dr. Sonia Raina
Please find attached both the files
Brief Answer:
no attached new files found
Detailed Answer:
Hello,
I am not getting any new attached file here. Kindly upload again. Alternatively you can mail it to YYYY@YYYY with subject as "Attn: Dr. Rajesh Teli".
I shall reply you.
My best wishes
Dr.Rajesh Teli
no attached new files found
Detailed Answer:
Hello,
I am not getting any new attached file here. Kindly upload again. Alternatively you can mail it to YYYY@YYYY with subject as "Attn: Dr. Rajesh Teli".
I shall reply you.
My best wishes
Dr.Rajesh Teli
Above answer was peer-reviewed by :
Dr. Prasad
I have already shared my TMT report and other blood reports through mail as size was big. hope you received the same. 2D echo is done looks OK will share the report in some time
Brief Answer:
your stress test is borderline
Detailed Answer:
hello,
I have gone through your tracing of TMT.In fact you have exercised substantially well and you did not have any symptoms.Besides it was supramaximal test with ST depression in only leads 3 and AVF which is not serious.It must have reverted to normal within one min of recovery.Hence i would consider your TMT as borderline with low probability of significant Blocks.You may avoid CT angio and continue your regular life style.Ofcourse go for annual echo and stress test.
My best wishes
Dr.Teli.
your stress test is borderline
Detailed Answer:
hello,
I have gone through your tracing of TMT.In fact you have exercised substantially well and you did not have any symptoms.Besides it was supramaximal test with ST depression in only leads 3 and AVF which is not serious.It must have reverted to normal within one min of recovery.Hence i would consider your TMT as borderline with low probability of significant Blocks.You may avoid CT angio and continue your regular life style.Ofcourse go for annual echo and stress test.
My best wishes
Dr.Teli.
Above answer was peer-reviewed by :
Dr. Prasad
dear Dr Thanks for your reply. I am extermily sorry I was struggling with app hence could not get your message on time by the time I had done my 2D echo and ct...I have shared both reports for your perusal. kindly check and advice. Thanks XXXX
Brief Answer:
your stents are functioning well
Detailed Answer:
hello,
I have see your echo as well Ct angio report.First of all let me assure that both your stents are fine and no need to worry.
If you go back to my previous reply you will recall that Positive predictive value of CT angio is less and in presence of heavy calcium one can not report on exact degree of narrowing.That's why I mentioned to avoid CT angio ,but i now can correlate ST depression in inferior leads in TMT report was due to lesion in RT coronary artery.If we correlate with TMT we can assume that lesion in RCA is not significant and can be managed with medical management,
If you want definitive evidence than only way is to go for routine angio.According to me it is not needed and you must follow healthy life styleand medications.If you have any new symptoms related to exertion then only you should plan for angiography other wise repeat TMT after one year ,
My best wishes
Dr.Teli.
your stents are functioning well
Detailed Answer:
hello,
I have see your echo as well Ct angio report.First of all let me assure that both your stents are fine and no need to worry.
If you go back to my previous reply you will recall that Positive predictive value of CT angio is less and in presence of heavy calcium one can not report on exact degree of narrowing.That's why I mentioned to avoid CT angio ,but i now can correlate ST depression in inferior leads in TMT report was due to lesion in RT coronary artery.If we correlate with TMT we can assume that lesion in RCA is not significant and can be managed with medical management,
If you want definitive evidence than only way is to go for routine angio.According to me it is not needed and you must follow healthy life styleand medications.If you have any new symptoms related to exertion then only you should plan for angiography other wise repeat TMT after one year ,
My best wishes
Dr.Teli.
Above answer was peer-reviewed by :
Dr. Prasad
Dear Dr XXXXXXX Thanks for being deatiled in your responses. I have no symptoms except I was anxious in last 2 days while waiting to see and interpret reports now I am feeling relax. I run for 7 km in a stretch followed by exercise instead tireness I felt relax.so all good just need moral boosting and confidence. Further my blood reports are fine then what could be the reason of RCA calcification?Is it elevated calcium ? I observed I am too dependent on calcium reach food such as milk , Chappati etc and cut down carb..Do you think I need good dietecien to consult with to balance my diet regime? Also help more detail on medication changes. ...Thanks XXXX
Brief Answer:
you just keep up present medication n life style
Detailed Answer:
Hello,
As such we don't know exact cause of calcification ,it is not related to high level of blood calcium or dietary calcium.
You simply follow your present approach
1.healthy food n exercise
2.avoid undue stress
3.continue medicines as prescribed .No need to change
4.Have regular check up.
This should be good enough to keep you Fit till 100!
My best wishes
Dr.Teli.
you just keep up present medication n life style
Detailed Answer:
Hello,
As such we don't know exact cause of calcification ,it is not related to high level of blood calcium or dietary calcium.
You simply follow your present approach
1.healthy food n exercise
2.avoid undue stress
3.continue medicines as prescribed .No need to change
4.Have regular check up.
This should be good enough to keep you Fit till 100!
My best wishes
Dr.Teli.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thanks Doctor, I was little concerned because after taking so much precaution still something found in arteries so what could be the reason. anyways thanks
Brief Answer:
some abnormality are due to genetics
Detailed Answer:
Hello
Certain abnormalities are contributed by genes which are beyond prevention that's why treatment is needed.
In your case life style is very important .
Don't worry much and follow the advise of treating doctor .yoga n meditation too will help you .
My best wishes
Dr.Teli.
some abnormality are due to genetics
Detailed Answer:
Hello
Certain abnormalities are contributed by genes which are beyond prevention that's why treatment is needed.
In your case life style is very important .
Don't worry much and follow the advise of treating doctor .yoga n meditation too will help you .
My best wishes
Dr.Teli.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
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