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I wanted to make sure if the attached EKG is good? Please comment.

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

Patient's Query

Hello doctor,

I just want to make sure if this EKG is good? No ischemia, or pulmonary embolism, or anything?

Thank you.
Answered by Dr. Ahmed Mohamed Mahmoud Goha

Education:

MBBS

Professional Bio:

Dr.Ahmed Mohamed Mahmoud Goha is a Cardiologist with 28 years of clinical experience. He completed his Cardiology and Cardiac Imaging Consultant in September 2019 Egypt-Air Hospital, Cairo, Egypt. He has worked in the following places- Clinical Cardiac Imaging Fellow (July 2014 to June 2019); In the Nuclear Medicine Division of the Medical Imaging Department, Western University, London, Ontario, Canada; As a Tele-Cardiologist (June 2010 – Present) in Caribbean Heart Institute, Jamaica; As a Senior Cardiology Specialist or Consultant Director of Cardiac CT unit (2003- 2014) in Aero- Medical council and Egypt air hospital; As a Cardiology specialist or Consultant (2002 –2014) in Saint Rita hospital, Cairo, Egypt; As a Cardiology specialist (July 2000 – July 2002) in Cardiology department of Defense industry medical Centre (DIMC), Cairo, Egypt; As a Cardiology Resident or Registrar (March 1996 – June 2000) in Cardiology Department of Kobry Elkobba Military Hospital, Cairo, Egypt. In addition, he did a Rotating Internship (Feb 1995 – Feb 1996) in the Faculty Of Medicine at Ain Shams University Hospitals, Cairo, Egypt.

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Hi,

Welcome to icliniq.com.

From the attached reports (attachments removed to protect the patient's identity), ECG is normal. There is no ischemia.

Thank you.

Patient's Query

Hello doctor,

Is there no pulmonary embolism either?

Thank you.

Answered by Dr. Ahmed Mohamed Mahmoud Goha

Education:

MBBS

Professional Bio:

Dr.Ahmed Mohamed Mahmoud Goha is a Cardiologist with 28 years of clinical experience. He completed his Cardiology and Cardiac Imaging Consultant in September 2019 Egypt-Air Hospital, Cairo, Egypt. He has worked in the following places- Clinical Cardiac Imaging Fellow (July 2014 to June 2019); In the Nuclear Medicine Division of the Medical Imaging Department, Western University, London, Ontario, Canada; As a Tele-Cardiologist (June 2010 – Present) in Caribbean Heart Institute, Jamaica; As a Senior Cardiology Specialist or Consultant Director of Cardiac CT unit (2003- 2014) in Aero- Medical council and Egypt air hospital; As a Cardiology specialist or Consultant (2002 –2014) in Saint Rita hospital, Cairo, Egypt; As a Cardiology specialist (July 2000 – July 2002) in Cardiology department of Defense industry medical Centre (DIMC), Cairo, Egypt; As a Cardiology Resident or Registrar (March 1996 – June 2000) in Cardiology Department of Kobry Elkobba Military Hospital, Cairo, Egypt. In addition, he did a Rotating Internship (Feb 1995 – Feb 1996) in the Faculty Of Medicine at Ain Shams University Hospitals, Cairo, Egypt.

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Hi,

Welcome back to icliniq.com.

No, this is normal tracing. There is only non-specific T wave inversion in the lead III, which does not mean ischemia or pulmonary embolism. ECG sensitivity is low in the diagnosis of ischemia or pulmonary embolism.

Thank you.

Patient's Query

Hello doctor,

I think I saw inversions in lead v1 to v3?

Thank you.

Answered by Dr. Ahmed Mohamed Mahmoud Goha

Education:

MBBS

Professional Bio:

Dr.Ahmed Mohamed Mahmoud Goha is a Cardiologist with 28 years of clinical experience. He completed his Cardiology and Cardiac Imaging Consultant in September 2019 Egypt-Air Hospital, Cairo, Egypt. He has worked in the following places- Clinical Cardiac Imaging Fellow (July 2014 to June 2019); In the Nuclear Medicine Division of the Medical Imaging Department, Western University, London, Ontario, Canada; As a Tele-Cardiologist (June 2010 – Present) in Caribbean Heart Institute, Jamaica; As a Senior Cardiology Specialist or Consultant Director of Cardiac CT unit (2003- 2014) in Aero- Medical council and Egypt air hospital; As a Cardiology specialist or Consultant (2002 –2014) in Saint Rita hospital, Cairo, Egypt; As a Cardiology specialist (July 2000 – July 2002) in Cardiology department of Defense industry medical Centre (DIMC), Cairo, Egypt; As a Cardiology Resident or Registrar (March 1996 – June 2000) in Cardiology Department of Kobry Elkobba Military Hospital, Cairo, Egypt. In addition, he did a Rotating Internship (Feb 1995 – Feb 1996) in the Faculty Of Medicine at Ain Shams University Hospitals, Cairo, Egypt.

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Hi,

Welcome back to icliniq.com.

T wave inversion is seen in V1 and V2 and not in V3, which is normal in young age females.

Thank you.

Patient's Query

Hello doctor,

No, I do not have any symptoms. But I thought you said I had an inversion on lead III. Now it is v1 and v2. I am confused.

Thank you.

Answered by Dr. Ahmed Mohamed Mahmoud Goha

Education:

MBBS

Professional Bio:

Dr.Ahmed Mohamed Mahmoud Goha is a Cardiologist with 28 years of clinical experience. He completed his Cardiology and Cardiac Imaging Consultant in September 2019 Egypt-Air Hospital, Cairo, Egypt. He has worked in the following places- Clinical Cardiac Imaging Fellow (July 2014 to June 2019); In the Nuclear Medicine Division of the Medical Imaging Department, Western University, London, Ontario, Canada; As a Tele-Cardiologist (June 2010 – Present) in Caribbean Heart Institute, Jamaica; As a Senior Cardiology Specialist or Consultant Director of Cardiac CT unit (2003- 2014) in Aero- Medical council and Egypt air hospital; As a Cardiology specialist or Consultant (2002 –2014) in Saint Rita hospital, Cairo, Egypt; As a Cardiology specialist (July 2000 – July 2002) in Cardiology department of Defense industry medical Centre (DIMC), Cairo, Egypt; As a Cardiology Resident or Registrar (March 1996 – June 2000) in Cardiology Department of Kobry Elkobba Military Hospital, Cairo, Egypt. In addition, he did a Rotating Internship (Feb 1995 – Feb 1996) in the Faculty Of Medicine at Ain Shams University Hospitals, Cairo, Egypt.

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Hi,

Welcome back to icliniq.com.

Let me clarify, and I did not mention the inversions in lead V1 and V2 because this is considered normal for young females, and the additional finding in the ECG was the T wave inversion in the lead III, which is non-specific. Did you have ECG as a part of a routine check-up? Do you have any risk factors for coronary artery disease (CAD), smoking, hypertension, DM (diabetes mellitus), high lipid profile, or a family history of CAD? I would like to assure you that the ECG does not indicate that you have CAD or pulmonary embolism.

Thank you.

Patient's Query

Hi doctor,

The ECG said borderline T abnormalities anterior lead. And I happened to be looking online, and it said different stuff. So I just wanted to make sure that it was not a pulmonary embolism. I am assuming that there are other things on ECG you look for PE.

Thank you.

Answered by Dr. Ahmed Mohamed Mahmoud Goha

Education:

MBBS

Professional Bio:

Dr.Ahmed Mohamed Mahmoud Goha is a Cardiologist with 28 years of clinical experience. He completed his Cardiology and Cardiac Imaging Consultant in September 2019 Egypt-Air Hospital, Cairo, Egypt. He has worked in the following places- Clinical Cardiac Imaging Fellow (July 2014 to June 2019); In the Nuclear Medicine Division of the Medical Imaging Department, Western University, London, Ontario, Canada; As a Tele-Cardiologist (June 2010 – Present) in Caribbean Heart Institute, Jamaica; As a Senior Cardiology Specialist or Consultant Director of Cardiac CT unit (2003- 2014) in Aero- Medical council and Egypt air hospital; As a Cardiology specialist or Consultant (2002 –2014) in Saint Rita hospital, Cairo, Egypt; As a Cardiology specialist (July 2000 – July 2002) in Cardiology department of Defense industry medical Centre (DIMC), Cairo, Egypt; As a Cardiology Resident or Registrar (March 1996 – June 2000) in Cardiology Department of Kobry Elkobba Military Hospital, Cairo, Egypt. In addition, he did a Rotating Internship (Feb 1995 – Feb 1996) in the Faculty Of Medicine at Ain Shams University Hospitals, Cairo, Egypt.

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Hi,

Welcome back to icliniq.com.

The typical ECG changes for pulmonary embolism are the presence of S1 in the lead I, Q wave in the lead III, and T wave inversion in the lead III. However, this is not the case in many cases. Pulmonary embolism is diagnosed primarily by symptoms, mainly shortness of breath, chest pain, fainting, with clinical suspicion due to associated hypercoagulable status such as post-operative, and deep venous thrombosis.

Thank you.

Patient's Query

Hello doctor,

I am a 40-year-old woman. The ECG that I sent you hopefully you can see it good? Does it not have any of the abnormalities? I just wanted to make sure it was good?

Thank you.

Answered by Dr. Ahmed Mohamed Mahmoud Goha

Education:

MBBS

Professional Bio:

Dr.Ahmed Mohamed Mahmoud Goha is a Cardiologist with 28 years of clinical experience. He completed his Cardiology and Cardiac Imaging Consultant in September 2019 Egypt-Air Hospital, Cairo, Egypt. He has worked in the following places- Clinical Cardiac Imaging Fellow (July 2014 to June 2019); In the Nuclear Medicine Division of the Medical Imaging Department, Western University, London, Ontario, Canada; As a Tele-Cardiologist (June 2010 – Present) in Caribbean Heart Institute, Jamaica; As a Senior Cardiology Specialist or Consultant Director of Cardiac CT unit (2003- 2014) in Aero- Medical council and Egypt air hospital; As a Cardiology specialist or Consultant (2002 –2014) in Saint Rita hospital, Cairo, Egypt; As a Cardiology specialist (July 2000 – July 2002) in Cardiology department of Defense industry medical Centre (DIMC), Cairo, Egypt; As a Cardiology Resident or Registrar (March 1996 – June 2000) in Cardiology Department of Kobry Elkobba Military Hospital, Cairo, Egypt. In addition, he did a Rotating Internship (Feb 1995 – Feb 1996) in the Faculty Of Medicine at Ain Shams University Hospitals, Cairo, Egypt.

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Hi,

Welcome back to icliniq.com.

I understand your concern. I assure you that your electrocardiogram (ECG) does not have these changes, and it is considered within normal limits. So you do not need to worry about the non-specific changes in the ECG. If you still have concerns, you may consider doing further cardiac investigations, which I think you do not need in the meantime.

Thank you.

Medically reviewed by Dr. Chithranjali Ravichandran
Published At April 11, 2021
Reviewed At July 13, 2023

Education:

MBBS

Professional Bio:

Dr.Ahmed Mohamed Mahmoud Goha is a Cardiologist with 28 years of clinical experience. He completed his Cardiology and Cardiac Imaging Consultant in September 2019 Egypt-Air Hospital, Cairo, Egypt. He has worked in the following places- Clinical Cardiac Imaging Fellow (July 2014 to June 2019); In the Nuclear Medicine Division of the Medical Imaging Department, Western University, London, Ontario, Canada; As a Tele-Cardiologist (June 2010 – Present) in Caribbean Heart Institute, Jamaica; As a Senior Cardiology Specialist or Consultant Director of Cardiac CT unit (2003- 2014) in Aero- Medical council and Egypt air hospital; As a Cardiology specialist or Consultant (2002 –2014) in Saint Rita hospital, Cairo, Egypt; As a Cardiology specialist (July 2000 – July 2002) in Cardiology department of Defense industry medical Centre (DIMC), Cairo, Egypt; As a Cardiology Resident or Registrar (March 1996 – June 2000) in Cardiology Department of Kobry Elkobba Military Hospital, Cairo, Egypt. In addition, he did a Rotating Internship (Feb 1995 – Feb 1996) in the Faculty Of Medicine at Ain Shams University Hospitals, Cairo, Egypt.

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Education:

BDS

Professional Bio:

Dr. Chithranjali is a passionate and skilled Dentist specializing in preventive care, restorative treatments, cosmetic dentistry, and oral health education. She excels in managing dental conditions with precision and compassion, ensuring patient comfort and positive outcomes. Committed to promoting long-term oral wellness, Dr. Chithranjali combines advanced dental techniques with personalized care, empowering patients to maintain healthy smiles and achieve optimal overall dental health.

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Dr. Ahmed Mohamed Mahmoud Goha

Cardiology

Education:

MBBS

Professional Bio:

Dr.Ahmed Mohamed Mahmoud Goha is a Cardiologist with 28 years of clinical experience. He completed his Cardiology and Cardiac Imaging Consultant in September 2019 Egypt-Air Hospital, Cairo, Egypt. He has worked in the following places- Clinical Cardiac Imaging Fellow (July 2014 to June 2019); In the Nuclear Medicine Division of the Medical Imaging Department, Western University, London, Ontario, Canada; As a Tele-Cardiologist (June 2010 – Present) in Caribbean Heart Institute, Jamaica; As a Senior Cardiology Specialist or Consultant Director of Cardiac CT unit (2003- 2014) in Aero- Medical council and Egypt air hospital; As a Cardiology specialist or Consultant (2002 –2014) in Saint Rita hospital, Cairo, Egypt; As a Cardiology specialist (July 2000 – July 2002) in Cardiology department of Defense industry medical Centre (DIMC), Cairo, Egypt; As a Cardiology Resident or Registrar (March 1996 – June 2000) in Cardiology Department of Kobry Elkobba Military Hospital, Cairo, Egypt. In addition, he did a Rotating Internship (Feb 1995 – Feb 1996) in the Faculty Of Medicine at Ain Shams University Hospitals, Cairo, Egypt.

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