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Heart & Cardiology/conduction abnormalities

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Question
QUESTION: Sir.. l had chest pain since 1 year. My recent ecg findings are as follows.. rate=84
PR=152
QRSD=98
QT=372
QTc=440
Axis P=57
QRS= -41
T=35 and it also shows R56L/RISIII/S12R56/S3RL and LAA/LAD
Iam on propranolol 20 mg medication since 1 yr.. what could be the diagnosis  and how to treat it

ANSWER: Hi,

Its difficult to give you a diagnosis with just the information provided. Other than chest pain are there other symptoms and has other work up been done. It would be useful to know what the echocardiogram shows. Also what was the view of the specialist you had seen so far?



---------- FOLLOW-UP ----------

QUESTION: No other symptoms are accompanied with chest pain.. am  feeling only chest pain

ANSWER: Hi, http://myheart.net/articles/angina-or-some-other-chest-pain/ http://myheart.net/articles/what-kind-of-chest-pain-is-it/ http://myheart.net/articles/still-more-types-of-chest-pain/

The EKG doesn't really explain chest pain. I have linked a number of articles above that outline chest pain and the different causes. If i were you i would have a check up with a dr to have your pain risk determined and to ensure you don't need further testing such as a stress test.

Hope that was helpful,



---------- FOLLOW-UP ----------

QUESTION: I underwent stress test two months ago.. Doctor said that test was negative for  cardiac ischemia...  but frequently am feeling chest pain.. am worried about it..  by professsion am a junior doctor just completed my mbbs.. i had  incomplete rbbb and left axis deviation.. does this conduction block progress to complete heart block... how long does it take for progression to complete heart block

Answer
Hi,

The combination of RBBB and LAHB is known as bifascicular block. Basically 2 of the 3 main conduction channels of the heart are diseased. Your heart will be able to conduct from the remaining channel however. Im assuming your exercise treadmill did not show any abnormality or worsening of the conduction also there were no other abnormalities noted, a normal echocardiogram would also be reassuring and in which case the treatment would generally be observation (if recommended by the cardiologist that has seen you) and of course you should seek immediate help if you developed very slow heart rate, dizziness or passing out for example as that may be a sign of progression of disease. The chance of the bifascicular block progressing to complete heart block is generally low studies suggesting that is less than a few % over a few years. The chance is lower in the case of LAHB as compared to LPHB. So while I would not worry, I would ensure you have regular follow up.

Hope that was helpful,  

Heart & Cardiology

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Mustafa Ahmed MD

Expertise

Cardiology, Interventional Cardiology, Cardiac Surgery, Hypertension, Pulmonary Embolism, Structural and Valve Disease

Experience

Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology

Organizations
http://blog.myheart.net

Publications
Multiple Publications In High Quality Peer Reviewed Journals. Internationally Recognized.

Education/Credentials
MD from The Royal Victoria University of Manchester, England Medicine, Cardiology, Interventional Cardiology, Research Training - University of Alabama

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