ECG help - QRS depression and prolonged QT segment.

[Muddymound]

DD2 (young adult) has had an ECG after she mentioned to the practice nurse during an appointment she gets occasional palpitations and tachycardia. She has ASD so she/we always put it down to anxiety and the stress of masking.

The ECG showed QRS depression and a prolonged QT segment. The GP has requested bloods and 24hour monitoring before another appointment. What can causes this? Do I need to be as worried as google has made me?

‘Depression’ is not usually a term used for QRS complex description. How significant the long QT is depends on exactly how long it is, what the other abnormality really is, and other things like medications, etc. GP is doing the right things and, with the benefit of being able to actually see the ECG, is in a much better position to advise your DD than anyone here.

Don't panic. This might be a mild ECG difference which isn't significant. The 24 hr tape will give more information than a brief ECG.

If the changes are significant it is FAR better to know about it so that changes to medication can be made ( if that is the cause) or a cardiologist can manage the condition if it is Long QT or similar.

Remember Dr Google gives you all the horror stories, not the stories of people whose further investigations turned out to be normal, or whose conditions are well managed.

As Greybeardy said - "depression" isn't a term used to describe the QRS complex.

Could they perhaps have said "small QRS", "low amplitude QRS", "low voltage QRS" or something like that???

When the QRS complex (the big tall spike you normally see on an ECG) isn't as big as you might expect they sometimes use terms like this.

It can be cause by a range of things - including thyroid problems (hypothyroidism). Goes back to normal when treated.

But it's worth bearing in mind ECGs in young people often look different to those from older adults - and some of these differences are considered variants.

It sounds like the GP is following up and a 24 hour recording with review will provide you with more information, and if necessary treatment options can be discussed.

I can appreciate it must be worrying, but it’s good that it’s being looked at.

A couple of thoughts.
Is she currently taking any medication? Some meds affect QT interval in some people.
How was the issue picked up? An HCP reading the ECG or a software interpretation? For safety reasons, interpretive software tends to overdiagnose, and as the machine is calibrated for adults who have more muscle resistance in their chests, patterns in teens, especially skinny male teens can initially appear to look a bit wild. Correct interpretation of intervals by a trained HCP will over come this.

Thank you for replying. I will get DD to check what the issue with the QRS complex is at the next appointment. She must have misheard as she thought they said depression.

Notagain you are right, I shouldn’t have googled but couldn’t help myself.

Cuck00soup I don’t know whether it was the HCP or software that detected it, I presume the GP as it was after the results were passed to them they called DD2. Although as I say that is just a presumption.

DD2 takes the pill, tranexamic acid and occasionally uses a ventolin inhaler.