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Is My ECG Report Abnormal Due To Relapsed Hyperthyroidism ?

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Posted on Wed, 2 May 2012
Question: Age: 30 Height/Weight: 168m/67kg.
Medical History:
May 05: Hyperthyroidism, treated with PTU for 8 month, stable XXXXXXX 08- Oct 10: Hyperthyroidism relapsed (confirm Grave Diease) TSH undetectable, treated with PTU. XXXXXXX 11: Hyperthyroidism- XXXXXXX treatment (15mci). XXXXXXX - Apr 11: reduced from PTU (3 pill to 1 pill), TSH still low.

Jun 11: Health Check.
Lipid profile, diabetes Mellitus profile are good.

These are slightly out of the range:
Total white cell count: 11.2
Differential count (Eosinophils): 5.36

Resting ECG Print out- Abnormality
Vent rate: 71 BPM, PR int: 193ms, QRS dur: 96ms, QT/QTc: 389/411 ms, P-R-T axes: 56 41 -18
Sinus Rhythm
T Wave abnormality, possible anterior ischemia (-0.1+ MV T Wave in V3/V4)

Question:
1. My doctor advise me not to run/scuba dive till I see a Caridologist, but my appointment with the Caridologist is going to be in 2 month time. I am planning to do some diving, can you advise, how serious is my condition based on my ECG? Can I proceed with all my normally sport activities?

2. Can the abnormal ECG cause by Hyperthyroidism or XXXXXXX treatment or consumption of PTU?

3. Does Total white cell count: 11.2, Differential count (Eosinophils): 5.36 out of range plus abnormality ECG means anything?




doctor
Answered by Dr. Prabhakar C Koregol (2 hours later)
Hi,

Thanks for the query.

If you are not having any chest pain, breathlessness or any other heart related symptoms, I dont see any major concern for the time bieng regarding your ECG though you would definitely need Cardiac evaluation if your doctor has suggested it.

In the absence of symptoms there is no need to curtail the physical activity based on the ECG finding described alone.

But I would strongly suggest you to reconfirm with your doctor if his advise is based on ECG alone or did he find something abnormal on your physical examination. In case there is nothing abnormal you can continue with physical and sport activity.

Thyroid disease can produce ECG changes. Radio iodine and PUT are less likely to reason for ECG changes

High White cell count and Eosinophils suggests a Bacterial or viral infection. This has to be correlated with any other findings. I dont feel it has to do any thing with ECG findings but does require complete evaluation.

Hope this answers your query. In case of any doubts, I am available for the follow ups.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prabhakar C Koregol (1 hour later)
Not sure if heart palpitations (fast) consider heart related symptoms.
It happened a week ago, I was sleeping than was awaken by it.

I did have a few heart palpitations (fast) occurance before I started my Hyperthyroidism treatment in 2005, but it have go away after my treatment.

As mention above, "Thyroid disease can produce ECG change", what types of changes can I expect. Does Hyperthyroidism causes any types of heart dieases/condition?

and

I do wish to find out the possible medical condition that I MAY have based on my ECG result.

I will definiately follow-up with a Cardiologist, but just need to check the risk level I am in, before I proceed for my scuba diving trip prior visit the Cardiologist in 2 month time.






doctor
Answered by Dr. Prabhakar C Koregol (3 hours later)
Hi and thanks again,

ECG changes produced by hyperthyroidism include:
1. Fast heart rate
2. Non specific st-t changes one which you have described.
3. Atrial tachyarrythmia
4. Occ bundle branch block

To define the risk level and and to suggest differential in your case is possible only if I can view the ECG record and noting the exact clinical findings. It would not be appropriate to comment based on the computerised interpretation - You may send the scanned ECG graph to my attention at YYYY@YYYY

Hope I have answered your query.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prabhakar C Koregol (16 hours later)
Please find my ECG graph which i have sent at YYYY@YYYY .
Hope you are able to define the risk level and to suggest differential in my case.
doctor
Answered by Dr. Prabhakar C Koregol (14 hours later)
Hi,

The ecg shows wide spread non specific ECG changes and does warrent further evluation.
Its most likely to be related to your

1. thyroid problem
2. Could be normal (Persistent Juvenile pattern)
3. Could be associated with pericardia or myocardial disease which will be known only after further evaluation.

Wish you good health.
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Prabhakar C Koregol

Cardiologist, Interventional

Practicing since :1998

Answered : 427 Questions

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Is My ECG Report Abnormal Due To Relapsed Hyperthyroidism ?

Hi,

Thanks for the query.

If you are not having any chest pain, breathlessness or any other heart related symptoms, I dont see any major concern for the time bieng regarding your ECG though you would definitely need Cardiac evaluation if your doctor has suggested it.

In the absence of symptoms there is no need to curtail the physical activity based on the ECG finding described alone.

But I would strongly suggest you to reconfirm with your doctor if his advise is based on ECG alone or did he find something abnormal on your physical examination. In case there is nothing abnormal you can continue with physical and sport activity.

Thyroid disease can produce ECG changes. Radio iodine and PUT are less likely to reason for ECG changes

High White cell count and Eosinophils suggests a Bacterial or viral infection. This has to be correlated with any other findings. I dont feel it has to do any thing with ECG findings but does require complete evaluation.

Hope this answers your query. In case of any doubts, I am available for the follow ups.