abnormal ECG readings?

[chemerunner]

I went to the ER for chest pain, nausea, and arm pain. I suspected heart attack, but enzymes were normal and I was released. ECG was also taken with the following results, and was flagged as abnormal and "pulmonary disease pattern" by the computer. I'm 24 yrs old, diabetic female. What do they mean and why are they abnormal?

Ventricular Rate               62 BPM
Atrial Rate                    62 BPM
P-R Interval                  160 ms
QRS Duration                  104 ms
QT                            450 ms
QTc                           456 ms
P Axis                         82 degrees
R Axis                        107 degrees
T Axis                         74 degrees

[is_something_wrong]

It means that the electrical forces in the heart draws rightwards. Which could be a sign that the right half of your heart (which is responsible for pumping blood through your lungs for oxygenation) could be under strain from something, but normally rightwards axis is a normal finding in young women.

Ask your doctor what his opinion is.

[chemerunner]

Thank you! I asked my doctor and he kind of brushed me off a little, saying that there WAS something abnormal in the tracings but he thought it was fine and maybe "it was just my normal." Last time I heard that, I was undiagnosed diabetic for a few years, so I am looking into a second opinion.

[chemerunner]

What is the overall axis then? Usually ecg axis is reported as a single number and I can't figure out how to calculate it.

[is_something_wrong]

You can read more about the electrical axis here:

http://en.ecgpedia.org/wiki/QRS_axis

"R axis" is similar to "QRS axis".

As you can see, a normal QRS axis is between -30 degrees and +90 degrees. Some sources say -30 to +105 degrees.

In general, younger people have a more rightwards axis than older. The left ventricle tends to grow with age, drawing the electrical forces leftwards. +107 degrees can be a completely normal finding. If you are in doubt, the next step could be an ultrasound of the heart to determine right ventricular pressure.

[chemerunner]

Thank you - I was worried about cardiac problems, but in the presence of "indeterminate axis" and "incomplete right bundle branch block" I am now worried about pulmonary hypertension.

I did a stress echo and while the doctor says everything is normal, I had tricuspid valve regurgitation. I know that is also found in pulmonary hypertension. He didn't measure pulmonary pressure so now I want a second opinion from a different doctor.