HomeAnswersCardiologyecgLips turning blue, pain in calf muscles and borderline ECG are bothering me. Please help.

How worrisome are my ECG findings?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. K. Shobana

Published At February 27, 2022
Reviewed AtJuly 19, 2023

Patient's Query

Hi doctor,

I would like you to explain the findings of my ECG. They are as follows normal sinus rhythm, incomplete right bundle branch block, borderline ECG. No previous ECG is available.

Hi,

Welcome to icliniq.com.

The following are the explanations of your ECG (electrocardiogram) findings. Normal sinus rhythm - the normal rhythm of the heart. IRBBB (incomplete right bundle-branch block) - a partial abnormality in the ventricular conduction pathway is present. It can be usually seen in the normal population. Borderline ECG (electrocardiogram) - no significant abnormality is present. You can upload your ECG (electrocardiogram) picture for accurate details. Thanks.

Patient's Query

Hi doctor,

Thank you for your response. However, I have some queries regarding what you have explained about my ECG findings. Partial abnormality in the ventricular conduction pathway is present. Do I need to consult a cardiologist for this? Is it a serious problem or could it get worse with time? Borderline ECG - no significant abnormality is present. Does this mean that there is a small abnormality and my ECG was not completely normal? Would any of these things be causing me chest pain and low oxygen levels? My lips turn blue while exercising and I also have pain in my calf muscles. I have also attached my ECG picture for your kind perusal.

Hi,

Welcome back to icliniq.com.

Please do not panic. I have seen the attached ECG (attachments removed to protect patient's identity). Here are the answers to your queries. A borderline ECG (electrocardiogram) varies from an absolutely normal ECG (electrocardiogram). IRBBB (incomplete right bundle-branch block) can be seen in a borderline ECG (electrocardiogram), as in your case but there is no need to worry about it. Other concerning points are your lips turning blue and low oxygen levels. Their cause should be found out. Check your SpO2 (peripheral capillary oxygen saturation) level. The normal level is more than 95%. An echocardiogram and based on its findings, a CT pulmonary angiogram may be needed to rule out pulmonary thromboembolism (PTE). IRBBB (incomplete right bundle-branch block) can also be associated with PTE (pulmonary thromboembolism).

Patient's Query

Hi doctor,

As suggested by you, I got my SpO2 level checked at the hospital. It was 99 to 100% and my blood pressure was also normal. I got my chest x-ray done too. It was normal with no nodules seen. At the beginning of the last year, I had a lung CT scan and an echocardiogram done as I had chest pain then. They were also normal. I have attached their report here. With all this in mind, would you recommend I get a lung CT done again?

Hello,

Welcome back to icliniq.com.

I have two concerns if you have shortness of breath on exertion, at rest, or both, Bluish discoloration of lips, tongue, etc on exertion, at rest, or both. Then only get a CT pulmonary angiogram done. A CT pulmonary angiogram checks the pulmonary blood vessels for any clots. An echocardiogram prior to a CT pulmonary angiogram is advised because, if there is PTE (pulmonary thromboembolism) then the echocardiogram will show raised right ventricle pressure which indirectly indicates a pulmonary pathology. What you had got done earlier was a plain CT (computed tomography) of the lungs.

Patient's Query

Hi doctor,

Thank you for your advice. I further want to know if the D-dimer blood test would rule this out?

Hi,

Welcome back to icliniq.com.

Yes, you can get the D-dimer test done; but if its result comes in a normal range and your symptoms persist, you would need to go for an echocardiogram and a CT pulmonary angiogram.

Patient's Query

Hi doctor,

Thank you for your suggestion. I will be consulting a general physician in two days. Do you think it is more urgent?

Hi,

Welcome back to icliniq.com.

I request you to please decide according to your symptoms. You can reach out to me for further queries.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Prashant Valecha
Dr. Prashant Valecha

Cardiology

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