Hi , Please Can You Confirm These Results Are Okay

Posted on Mon, 6 Jan 2020

Question: Hi , Please can you confirm these results are okay ? My 16 year old daughter had a 24 heart monitor fitted as she has been getting 10 second blackouts . She was due to have an endoscopy under General Anaesthetic but was postponed until they are happy with results from her heart test. My daughter took a note when she had the blackout at 19.27 and gave to the specialist.
Results are XXXXXXX HR 144bpm @22.19. min HR 61bpm @03.36 (1min avgs) mean HR 82bpm.
Patient diary 19.27 blackout, vision went black SR with episodes of ST up to 130bpm.
Please confirm if these results are normal enough to undergo a General for an endoscopy of her abdomen due to pain for 4 months

Answered by Dr. Ilir Sharka (25 minutes later)

Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome to Ask a Doctor service!

I passed carefully through your question and would explain that these ECG Holter findings are not considered a counterindication to the GI endoscopy.

So, it is OK to perform an endoscopy of the GI. I would just recommend taking a betablocker during the procedure, to help prevent possible episodes of ST.

You should discuss with her doctor on this issue.

I would also like to review a resting ECG image, if you could upload it for me to review, in order to be able to give a more professional opinion.

I remain at your disposal for any further questions whenever you need!

Wishing good health,

Dr.Ilir Sharka, Cardiologist

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ilir Sharka (1 hour later)

Thank you for the quick response . My daughter has had a resting ECG which came out normal. I just wondered why her BPM spiked twice, once to 144 and the other when she had a blackout at 130. Can this be normal and not related to the heart ?. The concern was her GP thought the issues with the blackouts were related to the heart,

I look forward to hearing from you.

Regards
Alka

Follow up: Dr. Ilir Sharka (6 minutes later)

Just to add if she hasn't got ST why would she need betablockers. Are you saying the results are abnormal then?

Answered by Dr. Ilir Sharka (28 minutes later)

Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

I understand your concern and would explain that the fact that betablckers should be used only during the procedure to prevent possible ST due to stress from the procedure although she has sinus rhythm most of the time.

This doesn't mean that this is an abnormal Holter result.

These spikes in heart rate are not concerning, considering her young age. They could be related to physical activity or emotional stress.

From the other hand, it is necessary to consider also other extracardiac causes that may lead to this clinical symptomatology, including epilepsy seizures and vasovagal syncope.

You should discuss with her doctor on the above issues.

Hope you will find this information helpful!

Kind regards,

Dr.Iliri

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Above answer was peer-reviewed by : Dr. Prasad