Can anyone interpret remarks on a ecg?

[KatyMac]

Had an ecg on Friday & "everything is fine, all normal"

Then I noticed this, don't really want to Google but I'd like a bit of help knowing if I should ask the GP about it

004 Normal sinus rhythm
150 Left ventricular hypertrophy
275 Abnormal repolarisation, possible coronary
ischemia
284 Prolonged QT interval

Thanks

I’m not medical but if I were you I’d ask the GP for more information about the notes on the ECG. They may well be not particularly significant but in the interests of medical transparency I think you should have been talked through them.

That makes sense

I do get het up about medical stuff

Although if anyone has anything else I should ask about I'd appreciate it

Is it your ecg or someone else’s?
How old is the person and what symptoms do they have?
It needs someone knowledgeable to look at the trace… automatic readings ( by the ecg machine) are unreliable
( from a rural GP who looks at lots traces)

Me I'm 55

I have CFS/ME fibromyalgia recently diagnosed possible subclinical hypothyroidism & a shitty menopause

I'm getting slower and less capable over the last 2 years and have had some falls and increasing general weakness (can't walk half a mile)

Oh and my bp has gone from 110/64 to 180/95 since oct

I think you need to talk to your doctor. You probably need bloods and an echocardiogram.

Also some drugs increase QT interval too!

Another ecg? That's from Friday
More bloods? They were done Thursday

I know - I'll grit my teeth and ring them, I'm such a wuss

Mis read echo cardiographer, ok

And prob different bloods

The ECG findings you've shared include:

Normal sinus rhythm (NSR): This indicates that the heart is beating at a regular rate, typically between 60 and 100 beats per minute.

Left ventricular hypertrophy (LVH): This suggests that the muscle of the left ventricle, the main pumping chamber of the heart, is thicker than normal. LVH can be caused by conditions like hypertension or aortic valve disease.

Abnormal repolarization, possible coronary ischemia: This finding indicates that there may be abnormalities in the electrical recovery phase of the heart. It raises the possibility of reduced blood flow to the heart muscle, known as coronary ischemia. It's crucial to investigate further to determine the cause and severity.

Prolonged QT interval: The QT interval represents the time it takes for the heart to contract and then recover. A prolonged QT interval can be associated with an increased risk of arrhythmias. It's important to identify the underlying cause and assess the potential risks.

What flagged for me was 'possible subclinical hypothyroidism'

Do you know your actual thyroid results?

Doctors are very good at telling you subclinical hypo won't cause symptoms but oh gosh, it can! It can cause heart symptoms! What you said about slowing down the past couple of years - that's how I've felt until now, finally diagnosed with hypothyroidism when I'm practically house bound. GP keen to tell me it can't be my thyroid causing such symptoms as my bloods aren't "bad enough" but a thyroid specialist quickly told me that yes, it can.

Just wanted to throw that out there. Many people are diagnosed with things like ME, fibromyalgia, heart palpitations etc before finding out they have a thyroid problem...

Thanks @TheBeeHives so its not unreasonable of me (wrong section!!) to ask for more info/reasons why it says those things

@DaisyCat33 I started on 25 levothyroxine in November "to see if I feel better" well I don't dramatically and we've been messing round with my hrt/testosterone during that time too
I feel like an old lady, my CFS/ME diagnosis is going to be 30 this year my FM is only about 16

Nov 23
Serum TSH level 5.61 mIU/L [0.27 - 4.2]; Above high reference limit
Serum free T4 level 14.5 pmol/L [12.0 - 22.0]

Sept 22
Serum TSH level 4.10 mIU/L [0.27 - 4.2]
Serum free T4 level 12.3 pmol/L [12.0 - 22.0]

Nov 21
Serum TSH level 7.00 mIU/L [0.27 - 4.2]; Above high reference limit
Serum free T4 level 14.6 pmol/L [12.0 - 22.0]

Jun 21
Serum TSH level 2.20 miu/L [0.27 - 4.2]
Serum free T4 level 12.1 pmol/L [12.0 - 22.0]

Nov 18 (after surgery to remove my ovaries)
Serum TSH level 2.87 miu/L [0.27 - 4.2]
Serum free T4 level 15.0 pmol/L [12.0 - 22.0]

Feb 18
Serum TSH level 3.18 miu/L [0.27 - 4.2]
Serum free T4 level 14.9 pmol/L [12.0 - 22.0]

In the interests of clarity my cholesterol has been high for a while and my blood pressure suddenly shot up, since I started the levothyroxine (coincidence?)

It's definitely worth asking the GP to explain the comments but do be aware that the ECG machine's interpretation is not always correct. It's just done by an algorithm and is not as good as a real person looking at the trace eg it can misread things that are obviously an artefact.

Thanks

What is an artefact please? It was all over my 24 hour trave a couple of years back and I never asked

I need to work out what's wrong with me, the GP is never the same twice, I've spent my life feeling like crap and the burst doing the ecg kind of laughed and said you do seem to have everything

An artefact is something external affecting the trace like you moving or someone touching the leads

Any comments produced by an ECG machine are usually ignored by professionals.

The machines over interpret everything.

I'm thinking my heart is a rabbit hole I can go down once we sort out the thyroid or the hrt....can't cope with too many balls in the air

Professionals never use the wording on the top of the ecg to interpret it, someone will review it. I would try to ignore it and ask the doctor, I know that's really hard. If you have ever had an ecg before it will also involve comparing it to previous ecg for any acute changes.

25mcg is an absolutely tiny dose. Not enough to do anything. It's a starter dose. Are you still on 25? I'm on 50 (for 4 weeks) and so far feel worse, have been told it's because I'm probably extremely undermedicated and will need to increase dose a lot. Few people need less than 100mcg. Have you had thyroid tests done since starting the levothyroxine?

High cholesterol and high BP are symptoms of hypothyroidism. Has your resting heart rate gone down? That is also a symptom.

Also - thyroid blood tests should always be done at 9am or earlier, having not eaten/drunk caffeine. If they're done in the afternoon they can be much "better" looking, and then GP says you're fine.

I made a post in December about my thyroid journey if you're interested in giving it a read. You may know all this stuff already, but many people on the thread were shocked how little they knew, how little their NHS GPs know about thyroid disease, and how badly it is treated in this country - so just incase you're in that boat! I was for a long time!

Hypothyroidism can and does affect the heart, because it affects your whole body. Your TSH at 5.61 is very definitely screaming hypothyroid as is your low in range FT4. Really you need FT3 measured, too, that will be the clincher. You look to have been overtly hypothyroid since at least Nov 2021 with the trend in that direction from at least 2018.

T4 is the storage hormone, you need to be able to convert it to T3 to get the active hormone that your body needs. Maybe you are not good at converting. You are taking levothyroxine you say - you aren't taking enough as a pp says, you need a dosage increase.

Raised cholesterol is a symptom of hypothyrodism, too.

Thanks @DaisyCat33 & @CrunchyCarrot

New thyroid test results have arrived

Serum TSH level 5.13 mIU/L [0.27 - 4.2]; Above high reference limit
Serum free T4 level 15.7 pmol/L [12.0 - 22.0]

And I think they have increased my levothyroxine to 50 I haven't got them yet and the note on the system is unclear

Would be nice if they considered talking to me

Yes you are still clearly hypothyroid. Your TSH needs to be close to 1.0. Your GP will be happy if it's just inside the top of the reference range, but that's not an optimum place and you would likely still feel hypo. Your free T4 is woefully low. It needs to be in the upper third of the range.

50 mcg is still likely too low for you, you may need around 100 mcg.

Best course of action? Request another blood test in 2 month (based on how many tablet they have given me?)

Yes best course is to start taking 50 if they've given you that, and you should need bloods again a few weeks later to see how it's trending. It is quite bad that your GP hasn't actually talked to you about all this. Could you get an appointment or a phone call to discuss it? Just so you know exactly what you're meant to do.