Dr. Sagar Ramesh Makode
Cardiology
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Patient's Query
Hi doctor,
I have postural tachycardia and abnormal electrocardiogram (ECGs). I have had an echocardiogram (uploaded) and a treadmill test and am currently wearing a holter.
Hello,
Welcome to icliniq.com.
I have gone through your reports (attachment removed to protect the patient's identity). Echocardiogram (echo) is fine; the whole one of the electrocardiogram (ECGs) shows prolonged Q-T, and in others, it is normal. So it is likely related to sinus tachycardia. So there is nothing to suggest any specific abnormalities in your report. All symptoms may be related to anxiety as well. Here, your threadmill test (TMT) is not attached, so please attach it and also attach both electrocardiogram(ECG) tracings so that I can review them. Also, your pheochromocytoma workup is negative. Do you have any hypertension? Have you checked your sleeping and standing bp and pulse rate? Kindly follow up for further assistance. Thank you.
Patient's Query
Hi doctor,
I could not get to my treadmill test, but it was negative and showed T-wave abnormalities. I saw internal medicine while in hospital as I have been very sick, and they were looking into postural orthostatic tachycardia syndrome (POTS) syndrome. My treadmill test only showed non-specific T- wave abnormality. So my echocardiogram was 100 percent normal? I, of course, could not understand some of it. Kindly advise.
Hi,
Welcome back to icliniq.com.
Your echo is normal. And yes, we have to rule out the possibility of postural orthostatic tachycardia syndrome (POTS) as well, and this can be done by taking sleeping and standing pulse rate and also blood pressure for any postural fall in blood pressure. Do you have access to Electrocardiogram(ECG) tracings.
Patient's Query
Hi doctor,
Electrocardiogram (ECG) tracing for the holter? I just got it on today and am wearing it until last week. I have been monitoring my blood pressure. I am on a beta blocker, so my blood pressure is good, but it rises when I stand instead of falling like thought it was common in postural orthostatic tachycardia syndrome (POTS). And I do not have access to any of the tracings, just the final reports. I did have one electrocardiogram(ECG) that said to consider ischemia, and that was when I was very symptomatic before I started my beta blocker, and I have had the echocardiogram since. My electrocardiogram (ECG) baseline seems to show T- wave abnormality and right axial deviation. Not sure what any of that means. As for my pulse before the Beta blocker, It would be about 80bpm when I was resting and jump to 150bpm as soon as I stood, with a jump in blood pressure and adrenaline rush going on for hours. I have been a lot better since I started medication for it, and besides, for the morning, my heart rate is good now.
Hello
Welcome back to icliniq.com.
Fine, firstly, I wanted electrocardiogram (ECG) tracing only to confirm Q-T manually. So if it is documented elevation in heart rate to 150 bpm, then it suggests postural orthostatic tachycardia syndrome (POTS). The possibility of ischemia in you is less, and also a negative threadmill test (TMT) makes it further unlikely. So, it is better to get more blood tests like sugar, autoimmune profile like antinuclear antibodies (ANA), anti-double stranded double nucleic acid, thyroid profile, and hemoglobin if not done. Also, a tilt table test will help confirm the diagnosis, so discuss these things with a local doctor whenever you visit him. Also, let us see the holter report. Kindly follow up for further assistance. Thank you.
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Cardiology
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