LAFB

[DavesFlaps]

Hello,

I visited my GP recently and while I was there she checked my blood pressure, as I have a history of hypertension but until now not enough to warrant medication. My result was enough for her to prescribe Amlodipine. Fair enough.
However she also sent me for an ECG and the hospital handed me the printout to take back to the GP which I obviously had a look at.
It says "Abnormal ECG" and "Left Anterior Fascicular Block"
Would appreciate if any PH medics can advise if this is particularly serious and if I'm going to die before my appointment next week.


Thanks

[Scabutz]

I am not a Dr, but I know drs don't mess around with heart issues. If you were in danger they wouldn't send you off with a print out to see your GP in a week.

Maybe don't run any marathons in the mean time.

[QuickQuack]

The ECG machine auto-interpretation is not infrequently a load of manure. The algorithms are designed never to miss an abnormality (ie be very sensitive) but at the expense of having a lot of false positives (lower specificity). Without seeing the trace, it would be impossible to judge. If you can post a picture here or PM it to me, I can give a better opinion.

PS although I no longer operate, I'm a cardiothoracic surgeon.

[DavesFlaps]

Thank You QuickQuack

I couldn't work out how to attach an image to a PM, so here it is with my personal data cropped.

[anonymous-user]

I don't think your lead II is negative enough to diagnose LAFB but quickquack sounds as if he'll know the definitive answer. I'd say it's more just left axis deviation.

[QuickQuack]

You have to have left axis deviation to be able to have a left anterior fascicular block by definition, and yes, this ECG does have left axis deviation to a mild degree. It is only just within the criteria for LAFB though, by just 1 degree, so I wouldn't be getting particularly excited about it. If you move the leads marginally you can make it disappear but you would still have the deviation. Given the history of hypertension, although the ECG doesn't fulfil the voltage criteria for clinical left ventricular hypertrophy, there will be some degree of hypertrophy and besides, the voltage criteria aren't infallible. Therefore, in the absence of any other symptoms, I would say that this is mild left axis deviation, likely to be physiological, age related and/or due to hypertension, and the LAFB on the automated report is not clinically relevant. Ignore and see your GP as planned

[DavesFlaps]

QuickQuack,

Thank you.

I really appreciate you taking the time to review this.