View Full Version : T wave abnormality
I have applied for a class one medical at Gatwick,
I have a Canadian licence, when I went for the class one medical in Canada they found an abnormal T wave, so they sent my ECG to a Canadian cardiologist and she OK’ed the test saying that I was 28 and in good general health and its just the way that I am put together. So I at Gatwick they find the same ECG problem (T wave abnormality – on the top of the sheet it said possible Myocardial Ischemia) this time they want me to do a treadmill ECG no-problem I think and then we do the test, but the cardiologist wasn’t in that day so I had to wait. Now I am being told that I have to do a 24 hour ECG and I am getting a little concerned and I may be referred to a local cardiologist for more tests after that. I am getting pretty worried about all this and was wondering if any body has been through a similar situation? Hopefully with positive results
Northern Chique
26th Apr 2006, 13:50
Without knowing what the specifics to your case, I can not turn around and guess what the final outcome will be, but hopfully your first Dr is right. You will pass the medical. I too, have been caught in a cardiac loop of testing. I have a fairly intimate knowlege of both my cardiologists waiting room. The thing is, for any deviation outside the published norm, there is a seeminly unending battery of tests.
Everyone has abnormal beats from time to time, and they have stipulated guidelines on what is acceptible for aviation standards. At the ripe age of 36 I had a series of cardiac events. (I was not having a good chrissy or new year) Subsequently I am grounded and have been since last christmas due to the delays in getting from specialist to specialist. Since then the piles of reports have been getting taller, and they have put the whole episode down to a virus or something similar. Believe me, I was pretty edgy after the after the third one! and pretty reluctant to come anywhere near pprune... It was too depressing.
Since then, I have had 12 lead ECG, Echocardiographs, 24 hour monitoring, stress ECG and all they have been finding is variations of normal. What they were looking for was a condition call R on T, which can develop into a life threatening arrhythmia in younger people. They didnt find it, and I now know what my heart looks like,what conditions the valves are in and so on. The Echo was the coolest medical test I've done, especially as the ultrasonographer explained what she was doing on the way through.
So given you have a normal healthy life, and no symptoms to speak of, I suggest they are just ticking off the relevant boxes. The cardiologist will have the final recommendation. So, just sail along with it, dont panic (that give false resting heart rates!) and let them tick the boxes until you hold the medical.
There are worse tests than an ambulatory 24 hour Holter monitor, believe me. And good luck, it sounds as if you are in good hands.
Northern,
Thanks for your reply; I hope that things will work out for you and thank you for sharing your experiences I have been told that my treadmill test was fine (the cardiologist said so) but my resting ECG showed some flat T waves and orthotropic beats (don’t know if that is spelt right) so he would like to do another resting ECG and then a 24 hour Holster test. I asked the receptionist when I booked if many people get them done and she said loads… that made me feel a bit better and they are very helpful at Gatwick. Thanks again Northern good luck and hope you get back to flying soon
captwannabe
26th Apr 2006, 18:05
I've had a few visits to the cardiologist too. They should be able to tell after an echo-cg whether there is anything to worry about (as in my case). They can measure the width of sections of your heart and see any abnormalities by doing this. I still have to get my cardio to notify the CAA, but it should be fine. Remember, if there is a problem, you can always fly commercially on a Class 2 in the US, without having to do an ECG. There are other ways to a cockpit. Don't give up your on dreams. At times like this, you realise just how much you want to fly. I hope everything goes well for you in the future.
Mr Magoo
27th Apr 2006, 09:23
I got referred about some ectopic beats spotted on my last yearly ECG.
Basically it's cost me £600 to find out I'm normal - but only after an echoECG a 24Hr holter ECG and various resting and treadmill ECGs.
It looks like those two cups of strong coffee I had before I went to my AME cost me all this hassle. If anyone's reading this with an ECG coming up cut out the caffine and the alcohol for a few weeks beforehand as weeks of worry and large medical bills ain't funny - trust me. :{
BelfastChild
27th Apr 2006, 10:03
Won't go into the specifics of your case as I am sure the docs are on to it. But just wanted to say that you should pay absolutely NO attention to what the print out says on the top of the ECG. More than often it is wrong and many ECG machines have this self reporting function switched off because it is crap. Anyway, hope it all gets sorted out soon for you
BOMB-DOCTOR
28th Apr 2006, 20:30
I'm a UK Class 1 holder and was advised of very flat T waves going back a few years ago during a routine annual medical. CAA made a bit of a fuss over it until they checked back to my original ECG completed at my initial medical 7 years earlier and found that the T wave inversion was present then. Nonetheless we pressed on with three years of periodical 24hour holters regular echos and exercise ECGs. (Apparently got the unofficial record on the exercise test - sorry couldn't resist:yuk: The T waves noramalised on exercise and returned in recovery. There is no doubt about it that the CAA were being cautious, but in the end I proved stability or they got bored or both.:ok: Did find a really pragmatic cardiologist who dismissed the whole thing and said be cool and do the time all will be well.:p
Bomb Doctor,
You are now a holder of a class one medical, from your post you had three years of medical testing for your heart, dose that mean that it took three years for you to get your class 1 medical?
BOMB-DOCTOR
29th Apr 2006, 06:42
Sorry for the confusion...
Yep, had a class one for seven years. After the anomoly was identified I had an OML (multi crew restriction applied). The OML was lifted after proving stability.
In your case one may be able to argue that this has been a long term thing for you already.
Perhaps the authority may consider your medical class 1 with the oml on to begin with but then keep tabs on you for a while?
:ok:
7gcbc
30th Apr 2006, 07:45
XYZ,
I can empathise with you regarding these "automatic" ECG assesments, It is stressful in itself to have these results come back, I myself had a similar situation last Jan, and did the whole shebang - stress ecg & echo but not the 24hr job.
Belfast Child is correct in what he says, my self reporting ECG machine reported an ST Elevation and Myocardial Infact and I had to wait a very uncomfortable mentally 2 weeks to find out it was early reploarization (re-alignment of heart position) due to my stature (tall and thin).
Only advice I can give is relax, stay off booze, and stimulants and you'll find in most cases that its a false alarm.
Northern Chique
30th Apr 2006, 09:29
The other item that than easily throw a diagnostic ECG is poor lead placement. Ive had one chap in for an ECG and the medic brought me the printout. I looked at it, and asked him did he recheck the leads and reanalyse. He said no. The thing is, as this chap was flight crew and he was only in for a medical, I thought the diagnosis on the top of the ecg was a bit over the top, given he should have been showing some significant symptoms.
I found the operator had some of the leads placed incorrectly. Once the leads were replaced in their correct locations, the ECG said normal. The diagnostic facilty in the machine can only interpret what information it can gather from the leads. Incorrect lead placement only can give an errant diagnosis.
captwannabe
30th Apr 2006, 11:10
The ECG seems to delay the whole medical, is often unaccurate, and adds considerable cost, so it begs to ask the question, why is it still a CAA requirement?
Also, I heard about a new method of lowering your blood pressure, relaxing your heart, and extending your life by 4/5 years. Spend ten mins a day looking at women's "upper-bodies". It's the equivalent of a 30 min aerobic workout. ;)
Tommy Tipee
30th Apr 2006, 11:10
Although my problem was not identical to yours, I had my Class 1 suspended by the CAA some years ago for an anomaly on my ECG.
I had to undergo exrensive cardiac testing, but eventually had my licence restored after 3 months.
I found the CAA cardioloigist very supportive with every effort being made to restore, rather than to revoke, my licence.
Things can seem to drag a bit at times, which is very frustrating, but be patient and hopefully you will soon be reinstated.
Northern Chique
30th Apr 2006, 22:25
Having used various types of ECG for quite a few years now for both diagnostics and monitoring, I have found they are only as accurate as the operator, and highly invaluable in diagnosis of varying cardiac conditions resulting in electrical activity changes. This type of diagnostic equipment has saved millions of lives world wide due to its ability to be used as a tool in a diagnostic role.
The 12 lead diagnostic ECG is not a predictor of conditions and only provides a few seconds window into the electric conductivity of the heart. In this role, other factors are taken into account. Even stress ECG's are limited in this capacity as they only provide a small window for the diagnostician to view.
Most folks have a baseline record in their first medical. This is usually used as a comparison for more recent records. Any changes can provide an alert to the DAME to start looking for other factors or symptoms.
Recommended DO and DONTs at your ecg (by no means hard and fast, but things I have found that work with most of the patients I have dealt with)
-Dont smoke within 30 mins of your ecg
-Dont leave your mobile on. Some mobile fields have been known to interfere with the analysis function of some ECG units.
-Dont speak or talk during the analysis. When the operator says "stay still", do that. There is a reason for it.
-Avoid stimulants such as coffee, soft drinks and so on
-Any medication normally taken, should be taken as normal
-Ensure an adequate fluid intake, such as water. Dehydration causes electrolyte concentration in the blood, thus changes to the electrical conductivty of the cardiac tissue can be noted. It also helps alleviate the embarassment of not being able to provide a sample for the urine analysis.
-get a good nights sleep prior to your medical exam. Sleep is a great stress reliever and can lower blood pressure as a result.
-eat properly. Turing up in a half starved, nervous state can give a poorer picture.
-find a DAME you like, and turn up early. Stressing out in traffic, trying to find car parks and so on can also cause a rise in stress levels.
-Take a good book.
-If the ECG looks doubtful, ask for another. Most clinics will do this at the DAMEs request. Remember, the machine is operated by a human.
My biggest hastle, was I knew something was wrong, and I happened to have a monitoring unit with me. This unit has 3 leads, but it still showed I had some changes to my heart conductivity. I knew that the prognosis wasnt going to be good for my medical.
The heart is a magnificently designed four chamber pump. Even when changes to normal occur, the pump still has the potential to operate effectively, however, in some cases, not as effeciently. Mine couldn't keep my blood pressure up, thus falling down without notice became a pass-time I have no wish to repeat. If anyone expresses an interest, I can give a quick rundown of the operation of this pump (I teach it for as part of my job). Knowing how it works in simple terms can alleviate some of the worry.
Thanks NC and Belfast for your professional input on this one. :ok:
Finally got my Class one (unrestricted) and am about ready to do some back flips I am so stoked!!