Dr. Anshul Varshney
Internal Medicine
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have attached two ECGs, one from recently and the other from last year.
Please discuss at length with no holding back on technospeak as to whether the latest test shows any improvement. Any information is appreciated like the severity of infarction, estimated time ago it happened, etc. It would interest me greatly to know whether the infarction occurred 55 years ago with a diagnosed rheumatic fever. Is it possible it was not rheumatic fever? I suffered a fall a few hours before the symptoms. No streptococcus involved condition. I was 11 and am now 66 years old.
Hi,
Welcome to icliniq.com.
ECG does not show any sign of infarction, rheumatic heart disease. It only has right bundle branch block that is a normal finding. Rheumatic heart disease is best diagnosed on echocardiography. ECG fails in that purpose.
Patient's Query
Thank you doctor,
I have attached ECG.
Hi,
Welcome back to icliniq.com.
Yes, this ECG has significant changes (attachment removed to protect patient identity). There are hyperacute inverted waves in lead 3 and AVF which signifies myocardial injury to the inferior wall. These changes can be seen in rheumatic heart disease, but they would have not been reverted. Since your latest ECG has no such changes, probably it has been an acute myocardial infarction at that time.
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Internal Medicine
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