Dr. Sagar Ramesh Makode
Cardiology
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
Hi doctor,
I am a 27 year old female. I went to the ER a few years ago, and I was diagnosed with pleurisy and anxiety. I only recently saw my records from that day. My EKG showed sinus tachycardia. My heart rate was 110 beats per minute, which I guess was due to anxiety or trying to breathe with pleurisy. I was also diagnosed with lateral repolarization abnormality. The doctor wrote "non-specific ST segment and T wave abnormalities" but otherwise normal EKG. I am really scared of this. I think that I have some kind of horrible heart rhythm that will lead me to just suddenly drop dead. I have severe health anxiety. Can you please help me interpret the attached EKG? Do I need to be afraid? I do not understand why the doctor would just let me go if it was something bad.
Hello,
Welcome to icliniq.com.
I have seen the ECG (attachment removed to protect patient identity). There are certain minor variations, which are quite commonly seen and considered as normal. So, there is nothing in your ECG, which is worrisome. Also, considering your age, the probability of any cardiac illness is less, and you also did not have any symptoms suggestive of heart disease. And echocardiogram was normal, so it also rules out any cardiac illness. So overall, there is no need to worry at all and ECG is also considered as normal. Hope this helps you and get back if you have any doubts.
Patient's Query
Thank you doctor,
Is the QT fine as well? My QTc was 438 ms with a heart rate of 110 beats per minute (QT was 323 ms). Bazett calculator said that this is approaching abnormally prolonged, but Framingham and Hodges's formula says it is too short. Why? When I typed in the 323 from the QT into the Bazett calculator, it mentioned that the QT itself was very low, but then gave me the same QTc of 438 ms that is on my EKG, and that some have said is close to the high range. Is it just that my 110 heart rate is throwing off the results? Do I need to be worried about an issue with my QT, especially with the "lateral depolarization abnormality" thing that was listed?
Hi,
Welcome back to icliniq.com.
QT changes with heart rate, that is, it decreases with increase in heart rate, which is a normal phenomenon and that is why it is corrected. And yes, these are compensatory changes due to tachycardia. Your QTc of 438 ms is absolutely normal, and no need to worry about it. In females, normal QTc is up to 460 to 470 msec. There is no need to worry at all, and there are no significant depolarization abnormalities in lateral leads as well.
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Cardiology
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