- 31 (almost 32)
I have a Complete RBBB, diagnosed for the first time about 10 months ago. At that time I had an EKG plus an ECG, plus a pulmonary function test. (PFT.) The PFT showed some minor abnormalities, but nothing indicating problems, at least not according to my doctor. (I can post those results if necessary. The common mention, though, over the past few years has consistently been, "Your lungs are huge. And very powerful. Are you a diver?" I'm not, though I was a tuba player.)
Since then I started walking/running 3-10 miles per day. I also lost 25lbs.
Last month I went into the doctor's office after my wife was able to hear my heart beat through my mouth. EKG then showed no change from the previous. "Am I looking at the same one?" The doctor asked. "This is identical." Still, he sent me to get a stress test. Cardiologist agreed with his recommendations and his sentiments, noting that the stress test was to make sure that all the bases were covered.
Had an ECG monday. Everything normal. In fact, things had gotten better than last year: My aortic root went down from 3.5cm to 3.1cm, for example, and the imaging of the right ventricular volume showed normal size (previously it was at 6.0cm, borderline normal/enlarged according to their measurements).
Today I had my treadmill stress test. Went 15 minutes without a problem, and stopped only when my heart reached 170/80 (and I was a bit out of breath). Prior to that, when laying down, I'd gotten an EKG (I think it was a 7-lead? 9-lead? She didn't do the legs, for example.) The EKG showed not just an RBBB, but also a Left Posterior Fascicular Block.
Previous EKG's - P/QRs/T Axis = 56/35/14. (Done exactly 1 month ago)
Today's EKG - P/QRs/T Axis = 96/168/34.
(I would offer more numbers, but I don't have a copy of today's EKG.)
Other than this, (and the pre-existing RBBB) everything was perfect. Despite this, the doctor said my prognosis was great, and that I could see an Electrophysiologist if I'd like. (I said yes. The appointment is for the 18th.)
My question: Could there have been lead placement issues at play here? If so, what? Today's EKG looked very different to the ones I've had previously. Also, I have a follow up appointment with my cardiologist on the 31st. (Happy Halloween, let's hope!) Should I make the appointment with the EP after the cardiologist? Or should I consult the EP prior to my follow up? And if correct, what could cause this kind of rapid change when all else seemed stable?
I don't think I'm in any eminent danger of death, which is why I don't mind waiting. I guess I just want to know what would be best, for the sake of information (and cost).
For reference, here were my previous EKG numbers:
P/QRS/T Axis: 53/35/14
Heart Rate: 73BPM
Sinus Rhytm Normal
- R > mV in V1
- R/S > 1 in V1
- QRS = 172ms
- RSR' in V1
S>30ms in I V5 V6
marked right-pericordial repolarization disturbance secondary to RBBB
- Large negative T in V2
- with negative T in V3*
*Note: Discussed this with the doc. She said it was a placing issue, the lead was a bit higher/lower than it should have been. The patterns, she said, still held up to the previous results.