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Heart & Cardiology/ECG changes and regional hypoiknesia



1) What does QRS notching in I and V3 on resting ECG mean, taken together with discrete regional (apical )hypokinesia of the RV as detected on heart echo?
a cardiac mri is recommended.

I am f, 27 years old. Within the last year, I have had two episodes of intense chest pressure radiating down to the right arm in which a strange sense of heaviness developed. I also have very fluctuating heart rate during rest (between 80 to 160)
Doctor said that the finding could be due to old, silent myocardial infarction, other causes of ischemia/vascular diseases and muscular diseases.

2) Could this finding also be caused by a tumor either in the myocard or in the pericardium? I just ask because there is some suspicion for a pericardial/myocardial mass.


Hi Sarah,
1): You may indeed have had an injury to your RV. The question then is: why? If due to a prior heart attack, there should be evidence of regional coronary artery disease and other cardiac risk factors. HR changes w/o exercise or stress need to be investigated further.
2): Pericardial disease may cause EKG changes, but I would expect this to be visible on your echocardiogram.
You need further investigations!
Hope this helps,
Dr T

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