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High Blood Pressure

BP and ecg

01/24/2008

Question:

I am in my early thirties, normal weight, and physically fit. My BP has been high lately (up to 145/90ish). My family doctor did an ecg and said "if you were an older overweight man I would think you had some previous cardiac event".

He sent me for bloodwork and an ultrasound of my heart, and the referral said:

"Abn ecg. Q`s I & AVL, and STs."

My ultrasound showed a mild mitrovalve prolapse, but nothing has to be done about it.

My question is, what does my ecg mean? Could it be due to my bp being high?

Thanks!

Answer:

Hello, and thank you for your question. In regards to the ECG interpretation, I must first state that without having viewed the ECG myself, that the following are general statements which may or may not be applicable in your situation.

The first issue is your borderline hypertension. You should ensure that you are incorporating life-style modification (i.e. proper exercise and diet (low in salt, high in fruits and vegetables), reduction in alcohol intake (if applicable), and did I mention proper exercise? :-)

As far as your ECG, one can only regard an ECG as abnormal if a previous one is available for comparison which denotes significant change, in other words, make sure these findings represent "new" findings. In general however, Q-waves and ST segment deviations are indicative of prior ischemic events such as a myocardial infarction. To be certain, you should ask your cardiologist.

An ECG does not determine whether one has hypertension but it can however reveal the effects of long standing hypertension (e.g. increased cardiac mass, prior heart attacks, etc.), so in a sense, the findings of your ECG may be reflective of your hypertension, or they could have been there for some time. My suggestion, given your age is that if the changes are real, you should follow up with a specialist right away.

Lastly, given your prolapse and elevated blood pressure, you need to ensure that you manage your hypertension. This could later adversely affect your cardiovascular fitness. I hope this information was helpful.

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Response by:

Kaine C Onwuzulike, MD, PhD Kaine C Onwuzulike, MD, PhD
Resident of Nuerological Surgery
School of Medicine
Case Western Reserve University