Someone in the know explain this please?

[Determined]

Hello All,

I've just had my Class 1 medical results over the phone today; apparently my ECG showed I had "Left Axis Deviation".

Basically, I have to go back to the cardiology department for more tests before they decide on whether to pass/fail me.

Apart from this, everything else came back fine. Can someone please tell me what the hell this is? Is it something to be worried about?

Naturally I'm rather cheesed off/devastated.

Regards.

[stagger]

If I remember correctly, the ECG axis is the vector of ventricular depolarization. Basically, it's the route that electrical signals take through the heart. Deviation can be caused by abnormalities in the structure and/or function of the cardiac muscle. Deviation to the left can have a number of causes but there is a certain amount of variation in the normal population so I wouldn’t worry about it too much at this stage. Left axis deviation in the absence of any other signs of heart problems could simply be a normal variant. Unfortunately, if this is the case you might have to undergo a few other tests to conclusively establish that your heart is essentially normal.

I think that innocent left axis deviation is seen more frequently in short, stocky people and innocent right axis deviation is more frequently seen in tall, thin people.

[Tarmach]

Determined,

Sorry to here this. Didn't the doctors or nurses when you had your class 1 medical give you some indication that your ECG looked a bit different and that you could be called back for further tests?

Tarmach

[Determined]

Stagger: Thanks for the info. I appreciate it. I'm just praying that these tests give me the all clear. Apparently only 0.5% of the population have this condition. As of yet, I have no idea if this is a disqualifying heart condition.

Can anyone out there shed any light on this?

Tarmach: No, the nurse took a look at the ECG when it was printed out and said it looked normal.

Thanks again.

[Tarmach]

Determined,

Thats almost obscene that you were told everything was ok when clearly there was some doubt over your ECG. The nurses should have seen enough of them to realise this, although I'm no expert!! I would have thought the doctor would have had a word to you before you left??

How long after your medical did you get this phone call- if you don't mind me asking.

Tarmach

[Determined]

Medical last Tuesday. Phone call on Thursday, told everything was fine except there was "an issue" with my ECG. Asked to call back Friday (yesterday).

Has been doom and gloom since Thursday. Tried getting any info on this from the internet with no luck. I'll book the tests on Monday (more money down the drain). Again, if anybody thinks the doctors are just being paranoid and it's not a big deal, please tell me!

[stagger]

The ECG axis needs to be calculated from the raw ECG data and small abnormalities may not be obvious when looking at the trace itself. However, most modern ECG machines calculate this sort of stuff automatically and will include an axis report on the printout. This will get automatically flagged if it’s sufficiently abnormal so anyone looking at the printout should be able to tell that there could be a problem. But the machine could mark it with something like “borderline abnormal” or “atypical” and the nurses might not have felt comfortable interpreting this – and it’s not really their job.

Anyway, try to stay positive. Without any other signs of underlying heart problems the axis deviation could turn out to be insignificant.

[ 18 August 2001: Message edited by: stagger ]

[KeithAlexander]

Whilst on the subject of ECGs, when i got mine it came back with Sinus Bradycardia, could somebody explain to me what this means?

[Code Blue]

Stagger's explanation is essentially correct. The main issue with Left Axis deviation is to establish any underlying cause - of itself it isn't disqualifying (in Canada). That process will involve further tests (and expense).

Sinus bradycardia is simply an otherwise normal ecg trace with a rate of 60/min or less. It is common in younger/athletic individuals.

rgds
CB

[NigelS]

It's no real surprise the nurse said it looked normal.. They're not the easiest things to read. When I worked in a hospital some years ago I was part of a ward entourage with a consultant. When he got to one bed he picked up the ECG trace that had just been done and was thumbing through it going "hmm, ah hmm! mmmm, hmm, uhu, uhuh" and so on. Each of us looked on until one brave young man leant over his shoulder and said "it's upside down sir". He continued hmming and ahhing before turning to the young medic and saying "you have to be very good to read them upside down you know!"

I wouldn't really expect this of a senior physician, and most any **** can see something basic like a prolonged T-wave. But in the grand scheme of things, they're not easy...

[evenflow]

determined..sounds similar to what happened to me. Had the initial class 1, and got a letter a few days later mentioning deviations on my ECG. anyway after a few sleepless nights I went back for the recall..they asked a few questions, did the ECG at rest again, and then did the ECG after walking on the treadmill for 10 mins (which is a lot harder than it sounds esp. when it starts going uphill). The doctor said it was fine and passed the medical. I was just relieved and didn't bother going into details but he said the abnormality was just something to do with my build and they need to check these things. Good luck!

[Determined]

Hi All,

For anybody who has read the previous posts, they will see that I had a few sleepless nights and extra expense after my initial medical due to a minor heart irregularity.

I'm now pleased to say that after the extra tests, I have now been approved for the Class 1. Just a warning to other wanabees not to worry too much if you are referred for further assessment. Just be prepared for the expense! (Spent over £1000 now on my medical).

I'd like to thank those who took the time to reply to my post. Thanks.

So Class 1 in the back pocket, just have to go see Mr. Bank Manager now...

A happy Determined.

[Marc Morrell]

Hi determined,

I am going through exactly the same at the moment, was told everything was ok and at Gatwick and then recieved a letter telling me I had Left Axis deviation and ectopic beats. After much expense, and 5 weeks after my medical, the CAA say they have approved my certificate but am still waiting for it to come through!

The lack of any real explanation throughout has added to my anxiety and I shant rest until that piece of paper is in my hands! You have my utmost sympathy - this has been a 5 weeks in total limbo,

Best of luck in your subsequent flying career,

FOM!

[cirrus driver]

ECG's are only as useful as the person reporing them.
Unfortunately they are frequently recorded by someone unskilled in reporting them but are analysed by software of inexpert nature which then produces a "report".

I am sorry for those who have been disturbed by this process.
One should always immediately ask to have a cardiologist look at the ECG in these circumstances.
Many times the computer is wrong or an incorrect result results from leads being misplaced.

Most of you who are fit and exercise should have sinus bradycardia on the resting ECG ( heart rate less than 60).
In fact many will have heart rates in the 40-50 range during sleep.

I have seen rates of 28 in sleeping endurance athletes.
In other words the ECG should NEVER be interpreted in isolation but only as part of the health review.

Cirrus driver
:)

[Al Weaver]

I had the Intensive care unit a little concerned when my traces showed a couple if instances of sinus pauses up to 4 secs long in the first 12 hours following open heart surgery. When my cardiologist showed me the traces two days later, I told him that I remember seeing those same traces on the monitor when I turned over in bed to look at the monitor. I wondered why the traces sort of flat lined with a very low freq. wave and then just gave up wondering and turned back to watch the soaps on TV. Since I seem to be doing fine walking the golf course every day a couple of months later I chalked it up to the leads coming lose when I turned over in bed.

[mach78]

El Keefo

Sinus Bradycardia is a reference to the Sinus Node, the heart's own natural pacemaker.
Bradycardia is, as been pointed out, a pulse rate of less than 60.
Notwithstanding the fact it can be a indication of fitness, it can also be pointer to underlying malignant conditions, which is of course what they are looking for.

As regards the ECG, this can be regarded as a picture of the electrical activity of the heart and unfortunately has its limitations.It can show previous damage to the heart but may not detect even quite advanced heart disease.
Hope this helps.

PS Nurse can't be blamed in the slightest.Interpretation by a Cardiologist is quite detailed-that's why i costs extra at our medicals to have it read.They pay attention to the slightest changes- which if they exist can cause excitment at the Belgrano, and even more so for the poor unfortunate concerned.

Trust me, I'm not a Doctor

[ 06 September 2001: Message edited by: mach78 ]