Patient's Query
Hello doctor,
I recently had a blood test and an ECG. My ECG report showed sinus rhythm with PACs and poor R wave progression. I would like to know what it all means?
Kindly help.
Hello,
Welcome to icliniq.com.
Your blood parameter reports are like complete blood count, white blood cells count, and lipid profile are normal except alanine aminotransferase enzyme and triglycerides, which are elevated. The remaining blood reports are normal with good HDL (high-density lipoprotein) cholesterol above the reference range (attachments removed to protect the patient’s identity).
Elevated alanine aminotransferase enzyme is seen in the case of liver cell or hepatocyte injury. This value needs further evaluation through clinical history and ultrasound of the liver.
About ECG (electrocardiogram):
PAC stands for premature atrial contraction, and it can occur in conditions like stress, pregnancy, alcohol, smoking, etc. In most cases, PAC is not a sign of heart disease and occurs naturally. If it happens occasionally or only once, it does not require any treatment.
However, if it is associated with symptoms like palpitations or flutter, lightheadedness, chest pain, breathing difficulty, you should seek a medical opinion and care.
Normal sinus rhythm means heart contraction impulse is happening at the natural pacemaker site (sinoatrial node).
Do you have any recent episodes of viral fever or drug toxicity? Kindly revert with the answers, and I suggest you get an opinion about your ECG finding from your local doctor also.
I hope this helps you.
Thanks.
Patient's Query
Hello doctor,
Thank you for your explanation.
I did not have any viral infection and also no drugs toxicity. Although I took painkillers (Paracetamol and Ibuprofen) for a while due to migraines, I also use a Ventolin inhaler every day.
I am also experiencing difficulty breathing every evening. I get wheezy, short of breath, and need to use the Ventolin inhaler to free up my breathing. At the same time, I get dull chest pain when I cannot breathe properly. The inhaler helps me breathe, but I am worried whether the inhaler may cause my liver problem?
What should I do now? Are there any further tests I could get to determine the cause?
There are no doctors in my locality, but it has a laboratory to do the tests needed. I will be traveling in two weeks where there will be a doctor.
What would be the next step for this? Do I need an ultrasound of my liver?
Please could you advise what to do next?
Thank you.
Hello,
Welcome back to icliniq.com.
Usually, alanine aminotransferase enzyme (ALT) and aspartate aminotransferase (AST) both get elevated in case of liver injury (acute or chronic).
In your blood report, only ALT is elevated, and elevation up to three times can be considered normal.
In liver pathology, a liver function test (LFT) is done to find the abnormality in the liver enzymes. The liver function test determines the values of AST, ALT, bilirubin, gamma-glutamyl transferase (GGT), alkaline phosphatase enzyme. Getting an ultrasound scan of the upper abdomen with a focus on the liver would help delineate any pathology if present, and it will help in a better diagnosis.
You mention using a Ventolin inhaler (Albuterol), which means your breathing difficulty is because of asthma. Occasional chest pain with no palpitation means PAC is also a rare finding in your ECG.
Any further tests related to cardiac, in my opinion, should be done after consulting the cardiologist.
If you prefer to do an ultrasound of the abdomen, you can attach the report to discuss it if you wish.
Thanks.
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Answered byDr. Basuki Nath Bhagat
Medically reviewed byiCliniq medical review team
Same symptoms don't mean you have the same problem. Consult a doctor now!
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