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How worrisome are my ECG findings?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

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.

Please advise.

Thank you.

Hi,

Welcome to icliniq.com.

I understand your concerns.

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 usually be seen in the normal population.
  • Borderline ECG (electrocardiogram) - no significant abnormality is present. You can upload your ECG (electrocardiogram) picture for accurate details.

I hope this helps you.

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.

  • A 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.

Please advise.

Hi,

Welcome back to icliniq.com.

Please do not panic.

I have seen the attached ECG (attachments removed to protect the 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 percent. 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).

I hope this helps you.

Thank you.

Patient's Query

Hi doctor,

Thank you for your response.

As suggested by you, I got my SpO2 level checked at the hospital. It was 99 to 100 percent, 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?

Please advise.

Hi,

Welcome back to icliniq.com.

I have two concerns: if you have shortness of breath on exertion, at rest, or both; and 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 done earlier was a plain CT (computed tomography) of the lungs.

Kind regards.

Patient's Query

Hi doctor,

Thank you for your response.

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 the result comes in a normal range and your symptoms persist, you would need to go for an echocardiogram and a CT pulmonary angiogram.

Kind regards.

Patient's Query

Hi doctor,

Thank you for your response.

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

Please advise.

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.

Kind regards.

Medically reviewed byDr. K. Shobana

Published At February 27, 2022
Reviewed AtOctober 18, 2024

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