Dr. Muhammad Zohaib Siddiq
Cardiology
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Patient's Query
Hi doctor,
I recently had an ECG as I have been short of breathe on exertion and occasionally I have palpitations and dizziness. The 12 lead ECG said sinus rhythm. QRS (T) contour abnormality. Consider anterolateral myocardial damage. HR 95 minutes. Intervals: RR 632 ms, P 96 ms, PR 116 ms, QRS 70 ms, QT 340 ms, QTC 430 ms. Axis: P 66, QRS 56, T 56, P (11) 0.13 mv, S (v1) -1.32 mv, R (v5) 1.39 mv, Sokol 2.79 mv. I am worried I may have heart damage such as cardiomyopathy. I think I may have had COVID-19 and have had ongoing episodes of tachycardia since. The doctors said they do not think there is any damage based on the ECG. Any help would be much appreciated. Should I push for more tests?
Hi,
Welcome to icliniq.com.
Your ECG (electrocardiography) is normal. The symptoms you described do not seem to be related to the heart. In your case, palpitations and shortness of breath on exertion may be due to anxiety, anemia, thyroid disorder, and sedentary lifestyle leading to deconditioning of heart, and even slight exertion causes shortness of breath and palpitations. Have you done CBC (complete blood count) and thyroid function tests in the recent past? Do you have diabetes? Echocardiography can be done to see the mechanical function of the heart. Echocardiography is not a must but can be done as feasible. Regular exercise, proper sleep, avoidance of anxiety, avoidance of sedentary behaviors can help.
Investigations to be done
Preventive measures
Patient's Query
Thank you doctor,
It is a relief to hear as I have heard many COVID-19 patients suffering from myocarditis leading to cardiomyopathy. When I read ‘QRS (t) contour abnormality consider anterolateral myocardial damage I thought it highlights cardiomyopathy damage. My full blood count was in the normal range, slightly elevated mean cell hemoglobin level at 32.4pg. Serum amylase is above the reference limit at 130 iu, and I am awaiting an ultrasound, thyroid test, and cortisol. I am highly anxious and have been sedentary since my illness. And I have been diagnosed with chronic fatigue syndrome and may have a problem with my nervous system. Could that be the reason for the contour abnormality suggested on the ECG?
Hello,
Welcome back to icliniq.com.
ECG (electrocardiogram) is the graphical representation of the heart's electrical activity. Slight changes can be due to improper placement of electrodes on the chest (especially in females), electrolyte abnormalities such as potassium and calcium levels in the blood (which affect the heart's electrical activity), and even fast heart rates. Your ECG is well within normal limits. Regarding myocarditis, it may occur in COVID-19, but myocarditis is suspected when there is confirmed COVID-19 signs, and symptoms of myocarditis, ECG changes, and echocardiography changes. In your case, symptoms are not specific for myocarditis. Moreover, your COVID-19 status is unknown. Your FBC (full blood count) is normal as well. So it is highly unlikely that you had myocarditis. Myocarditis is very symptomatic, and the patient comes with frank heart failure and pulmonary edema. Do not take stress, slowly start exercising, do meditation (such as yoga) as these reduce depression and stress.
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Cardiology
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