Patient's Query
Hello doctor,
I am attaching my recent ECGs along with readings for aerobic capacity and VO2 max. The VO2 max and aerobic capacity are estimated to be low because the exercise was interrupted after five minutes at a speed of 2.3 km/h, whereas I could have continued for at least five more minutes at a speed of 3.5 km/h. I underwent stenting two years ago. There were no symptoms, but the thallium stress test and subsequent angiogram indicated a blockage. I am also attaching my ECGs from six months ago when I was advised to get a pacemaker. I did not follow this advice as my ejection fraction was 73 percent, and I did not experience any symptoms of blackout or fainting. I am currently taking Rosuvastatin 5 mg, Telmisartan 20 mg, occasional Asenapine 2.5 mg, Oxcarbazepine 1200 mg, and Lamotrigine 300 mg, along with some nutritional supplements.
Can you tell me if there has been any improvement in the ECG? What would my aerobic capacity and VO2 max be if I were allowed 10 minutes of exercise on the treadmill, reaching a speed of 3.5 km/h? Do you have any other observations or advice?
Hello,
Welcome to icliniq.com.
I have reviewed your history and reports that show: patient exercised according to modified Bruce protocol for 5:0 (min:sec) achieving work level of MaxMETs 3. Resting heart rate initially was 35 bpm increased to max HR of 64 bpmResting blood pressuer was 130/80 mm of hg increased to maximum BP of 130/90 mm of hg.
You are not symptomatic; however, the ECG (electrocardiogram) indicated a rhythm block. You are experiencing a high-grade atrioventricular block, which affects the rhythm but not necessarily the blood flow. To assess the blood flow to the heart, angiography is needed. If the blood flow is adequate, the pacemaker will help regulate your heartbeats. If there is an issue with the blood flow, that must be addressed first, as it could be the cause of this rhythm block.
I hope this information helps.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
How can I regulate the rhythm block noninvasively? How can I assess the blood flow noninvasively? I will be undergoing a cardiac MRI and a CT scan of the coronary arteries in the near future. Can the suggested tests be conducted soon after these two tests, using the same contrast material? I would prefer not to undergo a full-blown angiography.
Hello,
Welcome back to icliniq.com.
You can assess the blood flow by performing a coronary angiogram. If the blood flow is adequate, then consider looking for other reversible causes, such as electrolyte imbalances, thyroid dysfunction, metabolic abnormalities, and any potential drug interactions. It is challenging to treat the first type of blockage noninvasively.
I hope this information helps.
Thank you.
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Answered byDr. Pramod Bhanudas Narkhede
Medically reviewed byDr. K. Shobana
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