I have a patient who is an athlete, has a history of panic attacks. Yesterday, he had palpitations, and some tingling was then sent for an ECG. The findings are sinus rhythm, marked right axis deviation, and ECG without any abnormalities. Would you be able to see it and assess what further steps I need to take?
Welcome to icliniq.com.
I reviewed carefully your ECG images (attachment removed to protect patient identity) and would explain that besides right axis deviation, I also noticed the presence of prominent P waves in DII lead, which indicates a pattern or left the posterior fascicular block. For this reason, I would recommend performing a cardiac ultrasound to examine the heart and exclude possible structural abnormality.
Regarding the tingling, I would also recommend checking the thyroid hormone levels and blood electrolytes for possible imbalance. I hope you will find this answer helpful. I remain at your disposal for any further questions whenever you need.
cardiac structural abnormality.Investigations to be done:
Thank you doctor,
What kind of pattern do you notice? Should I be getting this person to the ER?
Welcome back to icliniq.com.
I would not send him to the ER but would recommend avoiding strenuous physical activity until it is clarified that those ECG changes (large S waves in V1-V3 and axis deviation) do not correspond to any structural cardiac abnormalities. So, the next step is a cardiac ultrasound and if necessary a cardiac magnetic resonance imaging test.
Query: Hi doctor, My son is 12 years old, very active, plays representative basketball and attends a sports high school. Last Sunday, he was knocked over while playing and hurt his arm. After getting up, he fainted. He was fine after that. There were no broken bones, but the medical center did an ECG, and... Read Full »
Query: Hello doctor, I am a 20-year-old healthy young man. I do not drink or smoke but I do work a lot. I work for 60 hours actually and just moved out of my house with my family. I got my own new place as well as trying to maintain a relationship with my current girlfriend. I do not really have any health... Read Full »
Query: Hi doctor, I recently observed that my heart rate (including the resting one) is high. Resting rate is between 75 to 85 beats per minute and an average brisk walking rate is around 115 to 120 beats per minute. When I was unaware, I lived a perfectly normal life with 15 to 16 active hours. However, ... Read Full »
Ask your health query to a doctor online?Ask a Cardiologist Now