HomeAnswersCardiologyheart blockWhat does abnormal repolarization in an ECG report mean?

Kindly suggest some medicines other than Atacand to reduce my blood pressure.

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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. Chithranjali Ravichandran

Published At April 2, 2021
Reviewed AtJuly 7, 2023

Patient's Query

Hi doctor,

I am an 80-year-old female with some history of slight hypertension but without any other significant health issues. I am not on any medication at all. I usually measure my blood pressure and pulse once or twice a day to monitor it. Historically, my blood pressure has been in a band of 120/80 mmHg up to 140/100 mmHg or so. Over the last six months, I have occasionally experienced a lower pulse than normal, as low as 40 bpm. In the last week, it has been consistently 40 bpm, and blood pressure has been high at 160 to 200 mmHg systolic. There has been some fluctuation of this, but it is consistently higher than historically. I had a script for Atacand and have been taking up to 32 mg daily over the last week, but my blood pressure has remained high and my pulse low. I do not have any other symptoms. I have had an ECG done at the general physician. I have attached the image attached. Questions: Are there other drugs my doctor can consider other than Atacand to reduce my blood pressure? What does the ECG show? What is abnormal repolarisation in this context? Thanks.

Hello,

Welcome to icliniq.com.

Thanks for the query. Your 12 lead ECG (electrocardiography) shows the right bundle branch block and normal heart rate. The rhythm strip shows intermittent 2nd degree AV block. If you are not taking any rate slowing medicine, then this block can be due to an age-related degenerative process, which may progress to complete heart block. If this is the case, you will have to have a permanent pacemaker implanted. Regarding blood pressure, if it is not controlled with Candesartan 32 mg, then another medicine can be added to it, such as Amlodipine 5 mg initially. If still not controlled, then up titrate to 10 mg. Assess BP over a month or more. If still not controlled, then third medicine can be added. Abnormal repolarization is due to the right bundle branch block and is not significant.

The Probable causes

The probable cause is age related degenerative process leading to heart block.

Investigations to be done

Do TSH (thyroid stimulating hormone), serum electrolytes, echocardiography, renal function tests.

Treatment plan

Add Amlodipine 5 mg to Candesartan 32 or switch to Valsartan 160 mg plus Amlodipine 5 mg.

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

Dr. Muhammad Zohaib Siddiq
Dr. Muhammad Zohaib Siddiq

Cardiology

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