Abnormalities in Exercise ECG: What You Need to Know - Cardiology

More Info

---

Understanding abnormalities in an exercise ECG (electrocardiogram) is crucial for assessing heart health, especially when symptoms like chest tightness and shortness of breath are present. Based on the information provided, it appears that you have undergone both a resting ECG and an exercise ECG due to your symptoms. Let's break down the findings and their implications.


Key Findings from Your Exercise ECG
1. Maximal Heart Rate (HR): Your maximal heart rate reached 184 bpm, which is 101% of the maximum predicted heart rate (182 bpm). This indicates that you were able to achieve a high level of exertion during the test, which is generally a positive sign of cardiovascular fitness.

2. Blood Pressure Response: Your resting blood pressure was 133/88 mmHg, and it increased to 147/86 mmHg during exercise. This is a normal response, as blood pressure typically rises with physical activity.

3. ST Segment Changes: The most concerning finding is the ST segment depression of -1.45 mm in lead III. ST segment changes during exercise can indicate myocardial ischemia, which occurs when the heart muscle does not receive enough blood and oxygen, often due to narrowed coronary arteries.

4. Arrhythmias: You experienced 32 arrhythmias and 2 premature supraventricular contractions (PSVCs) during the test. While occasional arrhythmias can be benign, their presence during exercise warrants further investigation, especially in the context of your symptoms.

5. Exercise Duration and Workload: You completed 6 minutes and 49 seconds of exercise at a workload of 8.2 METs (Metabolic Equivalent of Task), which is a moderate level of exertion.

Interpretation of Results
The combination of ST segment depression and the presence of arrhythmias during exercise raises concerns about potential underlying heart issues. While the maximal heart rate and blood pressure responses are within normal limits, the ST segment changes suggest that there may be areas of the heart that are not receiving adequate blood flow during exertion.


Recommendations
1. Follow-Up with a Cardiologist: Given the abnormal findings, it is essential to follow up with a cardiologist. They may recommend additional tests, such as a coronary angiogram or a stress echocardiogram, to further evaluate the heart's blood supply and function.

2. Medication Management: Regarding your question about the heart rhythm medication (heart rhythm pills), it is crucial to follow your doctor's instructions. If your doctor has prescribed medication to be taken daily, it is important to adhere to that regimen, even if you feel well. If the medication is meant to be taken only during episodes of discomfort, ensure you understand the specific guidelines from your healthcare provider.

3. Lifestyle Modifications: In the meantime, consider making lifestyle changes that support heart health. This includes a balanced diet, regular exercise (as tolerated), stress management techniques, and avoiding smoking and excessive alcohol consumption.

4. Monitoring Symptoms: Keep a close eye on your symptoms. If you experience increased chest pain, shortness of breath, or any other concerning symptoms, seek medical attention promptly.


Conclusion
In summary, while your exercise ECG shows some positive aspects, the ST segment depression and arrhythmias are concerning and warrant further investigation. It is essential to work closely with your healthcare provider to determine the best course of action for your heart health. Remember, early detection and management of heart issues can significantly improve outcomes and quality of life.