Heart & Cardiology/New EKG with new notes

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Expert: David Richardson - 10/29/2009


Question

James' EKG 10282009
Hello Dr. Richardson,

You answered my question about a month ago about an EKG that was taken by my doctor.  Here's the link to the question/answer:
http://en.allexperts.com/q/Heart-Cardiology-964/2009/9/EKG-Results-little-scared...

I had another done today by my doctor's office and they gave me a copy at my request.  I've been having significant pain in the upper left area of my chest.  I've seemingly affected it by pressing my chest wall which leads me to believe that it's chest wall cramping, as you've mentioned in the past.

This particular EKG no longer mentions "Extensive ST elevation", however, it does mention "Poor R wave progression V2-V4, ST elevation also present.  Probable normal variant.  Summary: Borderline ECG."  

I'm attaching an image of the newest EKG for you to look at.  Would you kindly give me your opinion?

Thanks in advance.  

-James S.

Answer
Dear James,

I can't see your EKG.  It certainly sounds like a normal variant.   Placing the chest leads too high can produce poor R progression.  I think you can safely consider it normal.

David

Thanks.  I can see your EKG perfectly on the Rating Feedback.  It's normal.

David Richardson

Expertise

Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.

Experience

Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.

Organizations
Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Publications
Circulation, American Heart Journal, Hypertension.

Education/Credentials
M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.

Awards and Honors
Gold Heartt Award from American Heart Association in 1995.

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