Hello. My Husband Had A Biopsy Today To Confirm Cholangiocarcinoma

Posted on Tue, 26 Feb 2019

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 26 Feb 2019 Answered on

Last reviewed on

Question : Hello. My husband had a biopsy today to confirm cholangiocarcinoma. But my question is about his ECG. It is very abnormal, and seems to indicate one or two heart attacks. We'd like someone to explain what the ECG says.

Answered by Dr. Dr Sameer Maheshwari (1 hour later)

Brief Answer:
The ECG shows old heart attack

Detailed Answer:
Hi,
Welcome.
This is Dr Sameer cardiologist.
The ECG report says that the patient has a old heart attack.
It would be better if you send the tracing of ECG.
I will recommend 2D Echo for further evaluation.
Thanks and regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr Sameer Maheshwari (8 hours later)

Hello, and thank you.

I have sent the ECG tracing.

Please explain about:

1. Sinus bradycardia
2. Changes in initial forces of anteroseptal leads
3. New T wave abnormality in anterior leads
4. Low voltage QRS
5. And can you tell how long ago the heart attack occurred?

How bad is this ECG? He will be seeing a cardiologist this week, I am making the appointment today.

Thank you very much for your help. :)

Answered by Dr. Dr Sameer Maheshwari (29 hours later)

Brief Answer:
Please see detailed answer

Detailed Answer:
Hi,
welcome back.
First of all you didn't send the ECG tracing, it is just the reporting. I was asking for the graph.
To answer your questions
1) Sinus bradycardia is normal rhythm of the heart which is below 60 beats/min. It is normal until the heart rate becomes very low (usually <40bpm).
2) The rest of the things written are technical terms used to describe a ECG. Low force means R wave is not prominent which usually means he might be having a weak heart. New T wave abnormality in any lead generally signifies ischemia (decreased blood supply to a part of heart).
It is very difficult to estimate how long is the duration of heart only by seeing a ECG. We make a approximation by correlating start of symptoms and new change in ECG.
I recommend you to get a 2D Echo done soon to diagnose exactly whether he has a weak heart or a underlying heart attack.
Thanks and regards

Above answer was peer-reviewed by : Dr. Prasad