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Dr  S.A.Alam
Dr S.A.Alam, Doctor
Category: Medical
Satisfied Customers: 4448
Experience:  MBBS/FCPS(R)/MRCP(R) U.K
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My wife, who turned 74 years in October 2015, is due to have

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My wife, who turned 74 years in October 2015, is due to have a hysterectomy next February and, among other tests, had an ECG today to ascertain the method of anaesthesia. She had a heart attack in 2010 which proved to be 'minor' and no stents or surgery were required. She kept the ECG results from this attack (JUNE 2010) as she was told that these indicated her "normal" reading. The new reading taken today differs quite a lot in some areas which we don't understand ie: the rate shown then was 55, today it's 70; the RR was 1091, now it's 857; the PR was 226, now 205 and the QT has gone from 429 then to today it's 381. The AXIS readings show the P reading to have changed from -20 to 37 and QRS from -5 to -11. Other readings taken today differ little from those of 2010.
We have no idea of the significance of these changes but are worried that "Abnormal ECG" appears near the top of the page. Given that she is due to undergo major surgery soon do we have cause for concern about that in itself and/or her heart condition?
It should also be noted that she had breast cancer in 2003, with subsequent lumpectomy, chemotherapy and radiotherapy. The cancer returned in the same breast six years later which, thankfully (I think) turned out to be another primary tumour and not secondary. A mastectomy and further chemotherapy followed which was,in turn, succeeded by the above-mentioned heart attack. I mention this not knowing whether or not it has any bearing on her current ECG reading and would ask for guidance on this also.
I realise that this is a very lengthy question but thought that some background may help you in giving us some educated advice.
Thank you in anticipation,
***** *****
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Chip replied 1 year ago.
Hi.I understand your concern hereThe new ECG basically is a documentation of her previous heart attack with the axis change and the QRS change but nothing about it really is worrisome.That said, since she has had a heart attack in the past I would get a stress test to check out the status of her coronary arteriesLet me know if you need any more information please
Expert:  Dr S.A.Alam replied 1 year ago.
Latest guidelines on risk stratification in a cardiac patient tells us that there are two types of people who need further tests before a non cardiac surgery. high risk surgery like surgery at aorta or patient with active heart failure. ECG changes are not enough to put a person with stress test. So in your case if you do not have active symptoms of shortness of breath or chest pain you can easily undergo surgery at low risk.
Customer: replied 1 year ago.
Have I really paid £36 for that? More fool me!!
Expert:  Dr S.A.Alam replied 1 year ago.
Based on this evaluation both spinal and central anesthesia are ok and safe.
Expert:  Dr S.A.Alam replied 1 year ago.
The ECG changes are due to changes in the heart rate.
Expert:  Dr S.A.Alam replied 1 year ago.
only abnormal finding that has persisted is first degree AV block.Which is mild and is not a matter of concern for surgery.
Expert:  Dr S.A.Alam replied 1 year ago.
Other changes in the ECG parameters are due to change in the heart rate and do not signify a worsening or progress of the disease.
Expert:  Dr S.A.Alam replied 1 year ago.
Does this information helps ? I am assistant professor in cardiology and can help you further.
Expert:  Dr S.A.Alam replied 1 year ago.
Let me know If you have questions or need more assistance, thank you.
Expert:  Dr S.A.Alam replied 1 year ago.
Paul let me know if there is something left unanswered.
Expert:  Dr S.A.Alam replied 1 year ago.
Do not forget to rate positive, if no further questions, have a nice day.
Dr S.A.Alam, Doctor
Category: Medical
Satisfied Customers: 4448
Experience: MBBS/FCPS(R)/MRCP(R) U.K
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