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Heart & Cardiology/conduction abnormalities


QUESTION: Sir.. l had chest pain since 1 year. My recent ecg findings are as follows.. rate=84
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


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?

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

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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


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


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


Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology


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

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

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