Heart & Cardiology/right branch block

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Question
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Dr. Richardson,

Hello.  I'm white male in mid 40s with bad reflux.  Went to urgent care center with burning in chest, PA there did attached ekg as precaution.  They said I had possible right branch block + left atrial enlargement.  My questions are:

- PA said I should have follow-up Echo (should I get this and/or any other tests done?)
- is this anything to be concerned about?
- should I restrict my activity level?  I do moderate exercise and trying to get in better shape.

I've had PVC's for 15+ years, went to cardiologist back in 2010 - he did thallium stress test + echo - results normal.  Also did cardiac calcium score - result was zero.  When I have a can of mountain dew per day for a few days then I get the PVCs.  Here's the rest of my stats:

bp = 110/60
LDL = 150 (type A)
HDL = 55
crp = 0.7
alc = 5.2
BMI = 20 (always very thin)
meds = Prilosec, fish oil

thanks so much for your time,

Fred

Answer
Hello Fred,

EKG is very poor at reading left atrial enlargement, and RBBB is clinically unimportant.

1. Echo seems a good plan to relieve any worries.  I bet it will be normal.'
2. Probably no concern is needed.
3. No, don't reduce your activity.

Please write back if this note doesn’t answer all your questions.

David Richardson

Heart & Cardiology

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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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