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
Hello doctor,
I had an ECG (electrocardiogram) done three years ago, which showed up LVH (left ventricular hypertrophy), so I went and got an echocardiogram done, and it was normal. I had an ECG done again last week, and my doctor said it is still showing up LVH but more severe than three years ago. I am worried sick. I am sharing the pictures of my diagnosis here with you. Do you think I need another echocardiogram done? Also, can an echocardiogram change in three years? I also had a chest x-ray done last week, and it was clear and normal. Kindly help.
Hello,
Welcome to icliniq.com.
I have seen your reports (attachments removed to protect patient identity). How much do you weigh, and how is your built? (your weight is incorrect in your medical records). Now, if you are lean and thin, everything is normal because ECG can show left ventricular hypertrophy in lean and thin individuals, and the extent of hypertrophy may vary with weight and built. Can you obtain and attach ECG (electrocardiogram) tracings, both current and old ones? However, it would help if you took a cardiologist consultation as he has mentioned some ST depressions that do not appear to be convincing from the words he has used. And if these ST depressions are not significant on the ECG, then you need not repeat an echo, and if there are significant changes in an ECG only, then you should repeat an echo. You should also intermittently check your blood pressure to ensure that left ventricular hypertrophy is not related to high BP (blood pressure), which is the commonest cause for left ventricular hypertrophy. You need not worry much at the moment but should be evaluated to clear the doubt. For better opinion, it is advisable to attach the ECG. I hope this helps you and get back if you have any doubts. Regards.
Patient's Query
Hi doctor,
Thank you for responding. My height in centimeters is five feet. When I had the echocardiogram done three years ago, I was eight stone (110 pounds), and now I am ten stone (139 pounds) as I have put on weight after taking my MS (multiple sclerosis) treatments. My anxiety was terrible while getting my ECG done. My pulse was fast, showing 150 beats per minute. My blood pressure is normal when checked by the doctor. The hospital wrote that my ECG showed the same old T wave changes in lead III; what does this mean? I have also enclosed my echo report from three years ago. Thank you for listening. I am just so scared, kindly help me with your answers.
Hello,
Welcome to icliniq.com.
The old T wave changes in lead III of your ECG are common among females (attachments removed to protect patient identity). Nil acute means there are no new changes. So nothing significant in this statement. Your previous echo did not show any hypertrophy in the left ventricle three years back. There are mentions of nonspecific ST and T changes on ECG in summary, which are probably the same that your doctor has mentioned recently. So probably there are no significant changes now. Such changes can be falsely interpreted at a very high heart rate like you had (150 beats per minute). So there may not be anything serious at present, but do follow up with the specialist and let the specialist look at the ECG to confirm. So stop worrying about it at present. All the best.
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