Counterclockwise Heart Axis Deviation and Early Repolarization - Cardiology

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Hello Jackie,
Thank you for reaching out with your concerns regarding your recent health indicators. It's great to hear that you've made significant lifestyle changes over the past three years, successfully managing your weight and maintaining a healthy diet and exercise routine. Now, let's delve into the specific findings from your resting EKG and lab results.


Counterclockwise Heart Axis Deviation
The term "counterclockwise heart axis deviation" refers to a shift in the electrical axis of the heart, which can be observed on an EKG. The normal electrical axis of the heart typically ranges from -30° to +90°. A counterclockwise deviation indicates that the axis is shifting towards the left side of the body, which can be caused by various factors, including:
1. Left Ventricular Hypertrophy (LVH): This can occur due to high blood pressure or other conditions that increase the workload on the heart.

2. Left Bundle Branch Block (LBBB): A blockage in the electrical conduction system of the heart can alter the axis.

3. Myocardial Ischemia: Reduced blood flow to the heart muscle can also affect the electrical activity.

4. Structural Heart Changes: Conditions such as valvular heart disease or cardiomyopathy can lead to axis deviation.

In your case, since you have no reported history of heart disease and have been actively managing your health, it may be worth discussing with your physician whether further evaluation is necessary, especially if you experience any symptoms like chest pain or shortness of breath.


Early Repolarization
Early repolarization is a term used to describe a specific pattern seen on an EKG, characterized by a J-point elevation and a slurring or notching of the terminal portion of the QRS complex. This finding is often considered benign, especially in younger individuals and athletes. It has been associated with a lower risk of cardiovascular events in many studies, but it can sometimes be confused with more serious conditions like Brugada syndrome or other arrhythmias.


Fibrinogen and White Blood Cell Count
Your fibrinogen level is slightly low at 184.1 mg/dL, while the normal range is typically between 200-400 mg/dL. Fibrinogen is a protein produced by the liver that plays a crucial role in blood clotting. Low levels can be associated with several conditions, including liver disease, disseminated intravascular coagulation (DIC), or inflammatory states. However, if you are otherwise healthy and asymptomatic, this finding may not be of immediate concern, but it should be monitored.

Your white blood cell (WBC) count is also slightly below the normal range at 4.32 x 10^9/L (normal range is typically 4.5-11.0 x 10^9/L). A low WBC count can indicate a variety of conditions, including bone marrow disorders, autoimmune diseases, or the effects of certain medications. Again, if you are feeling well and have no symptoms of infection or other health issues, this may not be alarming, but it is worth discussing with your healthcare provider.


Conclusion
In summary, while your resting EKG shows some unusual findings, they may not necessarily indicate a serious problem, especially given your healthy lifestyle and lack of symptoms. However, it is essential to follow up with your healthcare provider for a comprehensive evaluation, which may include further testing or monitoring. They can provide personalized advice based on your overall health status and any potential risks.

Continue with your healthy habits, and don't hesitate to reach out to your doctor with any further questions or concerns. Your proactive approach to your health is commendable, and staying informed is key to maintaining your well-being.

Best wishes for your continued health,
Doctor Q&A Teams