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Abnormality in ECG with fast heart beat. Need ECHO?

Resolved Question:

I went and did an ecg recently and wanted your opinion.

The lady said i should do an echo after viewing the results.

She said that the 22 is not a good value and i may need to do an ecg every 3 months....but i must admit that i was scared when i was there so my heart rate would have gone up.....

When i test my heart at home i get around 80-90

i did echo twice before because my gp said he heard a murmur and wanted me to check it out.....

up to last year i did an echo and the specialist said its just a fast heart but nothing bad is showing up with the heart.......

Anyway what do you think of this results.....should i go and do an echo again just to be on the safe side????

https://drive.google.com/file/d/0BwTm33_BGAcAU2lVYkZnQ3dVODQ/view?usp=sharing
https://drive.google.com/file/d/0BwTm33_BGAcATjBDT01YcEdjb2c/view?usp=sharing
https://drive.google.com/file/d/0BwTm33_BGAcATnFWendVTHdRVVE/view?usp=sharing


Category: Cardiologist

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Category: Cardiologist
Dr. Vivek Mahajan is online now

Expert:  Dr. Vivek Mahajan replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com

What is the complaint that made you get done the ECGs over last one year?
what are the complaints for which 2d Echo was done last year?
What are your current complaints? Are they the same complaints that prompted you to get ECGs and 2D echo done over the last 1 year?
What is your age and gender?
Do you have comorbidities like hypertension diabetes etc?
Do you have family history of sudden cardiac deaths
Do you have symptoms like palpitations dizziness giddiness black outs?

Kindly reply to the above questions, and then i can guide you further
Regards,
Dr Vivek Mahajan


Patient replied :



the first time i went i was getting chest pains.....i did an xray and the doctor said that my spine is a but curved and nearly close to my heart so that is why i would sometimes get pain and he told me i should probably lift some weights......
the second time i went was because my gp thought i had mal fan syndrome or something like that and he did not like the murmuring sounds.....
when i went to the specialist he said i dont have mal fan syndrome and the heart valves and everything is good just a bit fast heart rate.....
This time when i did the ecg i did it cause one of my friend owns the place and he ask me to check it out....
the only main complain i have is sometimes i may feel pain but not often....i think i get palpitations sometimes but not giddiness or blackouts.....
i dont have hypertension, diabetes etc
i am 31 years old patientold and male. I am underweight. only weight around 85 pounds.....
and yea basically the complaints are the same as previous years.....
no familyt history of heart attacks




Expert:  Dr. Vivek Mahajan replied 3 Days.

Thanks for the reply.
You have pain as the major complain. For this ecg and echo has been done . Now you don't have any fresh complaints except for the same pain that you already have. I am not sure whether you really have the spine defects but what I feel is that due to chest deformity electrical current vectors may change and you could have abnormal ecg patterns due to abnormal positioning of the heart. In that case it wouldn't be appropriate to apply the heart stress index as the ecg would be interpreted as if for a normal positioned heart and woild obviously cone out as an abnormal heart stress index.
In view of prior normal echo and no fresh complaints I would not recommend any further echo test for you so long as you don't have any other fresh cardiac issues,

Regards
Dr Vivek Mahajan


Patient replied :

ok so what you are saying that the xray that i took showed that my chest was deformed and thus my heart is located somewhere else??


Expert:  Dr. Vivek Mahajan replied 2 Days.

Hello,

I haven't seen the xray personally. So it is difficult to say for me whether your chest is deformed. You have mentioned your chest being deformed in the previous mail. If that is true then the heart maybe deviated frim its normal position and angulation. I am not saying it is located elsewhere. However it may be slightly differently placed like minor shift of position or angulation. This could lead to some ecg abnormalities. And hence the vector analysis applicable in normally placed hearts may not be applicable here.

Regards
Dr Vivek Mahajan


Dr. Vivek Mahajan
Category: Cardiologist
Experience: 
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
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