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Old 4th Jun 2006, 22:35   #1 (permalink)
 
Join Date: Aug 2005
Location: UK
Age: 34
Posts: 99
Red face T wave inversion in the inferior lead.

UPDATED AT BOTTOM OF THREAD!!!!!!


what is all this about???


Had my medical with an ECG last month which i passed.

Just had a letter from the CAA sayin i have had my mediacl revoked cos of an inversion in the T Wave!!


Know idea what its all about!!

Im 26,tall, thin and healthy!

Last edited by Longchop; 9th Jun 2006 at 20:10.
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Old 5th Jun 2006, 01:07   #2 (permalink)
 
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My mother had inverted T waves for 55+ years I'm aware of. She lived to be 93 with no heart problems.

Your mileage may vary.
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Old 5th Jun 2006, 11:54   #3 (permalink)
 
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If you think they are wrong ask for a re-test and hire an expert to give you an independent opinion.
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Old 5th Jun 2006, 13:45   #4 (permalink)
 
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T- wave inversion in the inferior lead aVF or III, as was mentioned in the absence of symptomology, and cardiac enzymes Troponin C and such, is generally physiologic, in fact many normal individuals present with tachyarrythmias, bradyarrythmias, and ST segment and T- wave inversion, axis deviaions and even runs of V-fib yet there's no EKG to continuously monitor them. if you don't pass after a retest you may require electrphysiology testing 'cath lab' to completely rule out pathology---a bit ridiculous with out angina or cardiomyopathy--- at least for the non flying

edited to add inferior is lead III... forgot an I

Last edited by rhovsquared; 25th Jun 2006 at 20:34.
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Old 5th Jun 2006, 19:28   #5 (permalink)
 
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Ok, I see.

Read out on the top right of my ECG printout says-
SINUS RYTHM
ST-T changes in inferior leads
THESE CHANGES ARE UNUSUAL FOR A MALE OF THIS AGE BUT ARE NOT DEFINITELY ABNORMAL
SUMMARY: BORDRLINE NORMAL
**UNCONFIRMED REPORT**



Need to see a cardiologist for further investigation.


Funny thing is, 6 years ago, I had the same kind of problems only that time they said i was a candidate for LVH! This was checked by a cardiologist who did an echo scan and completely ruled out LVH or any other underlying patchological coindition! These abnomalities were put down my build and body type.


So,here i am 6 years later with the same problem and now im feckin grounded!



CAA have said this is a temporary measure and i shouldnt owrry as an ECG review is purely for certificatery reasons and is unlikely to represent a significant health risk.

Question, If its not a significant health risk then why have they grounded me?


If i have to have a cardiologists report every time i have an ECg then im gonna be a very annoyed chappy!

Last edited by Longchop; 5th Jun 2006 at 20:01.
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Old 5th Jun 2006, 23:06   #6 (permalink)
 
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Presumably, once the ecg and you have been assessed, the caa will be looking for any changes at subsequent medicals. As long as there is no change, you shouldn't have to go through the rigmarole again.

QDM
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Old 6th Jun 2006, 15:27   #7 (permalink)
 
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I think rhovsquared kind of eluded to this, but the reason they are making a big deal out of this is because typical T-wave inversions are associated with a previous ischemic event. It doesn't neccassarily means that has happened, and it would probably wise to follow up on it and get yourself cleared. As a general rule (not 100%), but it will stay on your future 12-leads. Hope that helps.
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Old 7th Jun 2006, 00:10   #8 (permalink)
 
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Echo was fine today,perfectly normal with no abnormalities.

ECG today showed flat T-waves as opposed to the inverted ones on my previous ECG.

Excersice ECG is on Friday........if that shows a good recovery from my excersice then all is well!

Cardiologist thinks the CAA have over reacted in grounding me.....should have given me the standard two months to allow me to get it checked whilst still being allowed to fly.
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Old 9th Jun 2006, 20:09   #9 (permalink)
 
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Excercise test was today.

Result is as follows-


Completed 11minutes on the Bruce protocol test attaining a max heart rate of 200BPM (103% or maxiimum predicted for age)
Maximum workload attained was 13.4METS. Resting BP was 111/72mmhg rising to 196/61mmHg at maximal exercise.
The pataient was free of chest pain throughout the exercise.
Exercise was terminated due to patient achieving and exceeding his maximal heart rate for a period of 60secs.
S-T segment depression was first noted at 4minutes of exercise and became significant in the inferior and lateral leads. Maximum S-T segment depression was -3.00mm was recorded in leadIII at 9 minutes and 29 secs of exercise. The S-T segment changes persisted until 11 minutes into the recovery phase.
Nil else of note.


Report stated-

St and T-wave morphology in the inferior leads. Further investigation into this would be prudent to ascertain if there are any coronary artery abnormalilities or other conditions.

Cardilogist suggests a Dobutamine scan and a cholesterol test.


Now add to that a perfectly normal Echo Scan with no underlying heart disease.

Where do i stand now???

Am i Ill??

Am i going to die??

Am i going to lose my license??

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Old 13th Jun 2006, 20:55   #10 (permalink)
 
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Normal variant.

Class 1 unrestricted....I thank you!!
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Old 13th Jun 2006, 21:36   #11 (permalink)
 
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Longchop,

Congrats !! Glad you got cleared. As I mentioned, my mother ( an RN ) had T-wave problems for a very long time. She lived to be 93 when she got careless while wrestling an alligator.
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Old 14th Jun 2006, 06:15   #12 (permalink)
 
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Hi Longchop, glad you got your Class 1. Have been following your thread. You were getting a bit down in the dumps so good to see you get through.
Nice to see a CAA somewhere who have people who think about the pilots.
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Old 16th Aug 2006, 00:40   #13 (permalink)
 
Join Date: Oct 2003
Location: -26.412, 146.262
Age: 52
Posts: 714
I have just had my class1 Ecg queried due Sinus rhythm and occasional VEC's (i think that it what is written on the report.)
this is the first bad report for me. I am 43 and weigh 65 kg's. I gave up smoking a year ago.
the ecg says
H-R 66 bpm 842-4 ventricular premature beat.
R-R=904ms-701-4 Poor R Progression.

I have been given a months extension by CASA till 27/9/06.

I am seeing a cardiologist next week along with stress ECG and echo and halter monitor.

can anyone tell what this all means.
my AVMED doctor was not at all concerned about the ECG (he took it).

185.
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Old 16th Aug 2006, 01:19   #14 (permalink)
 
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Location: NY
Posts: 278
185skywagon: Um, think the stress test and echo would definitly rule out any gross EKG anomalies which are present on nearly every one HR 66 low normal,
R-R interval gives HR little 1mm squares are .04 sec or 40 ms, each Rrepresents a ventricular depolarization (sort of correalated with the heard heart beat] VEC= ventricular ectopic contraction, in lay terms a 'extra heart beat', as far as the R-wave progression: well I don't trust computer generated EKG reports, so if you don't mind, PM me I'll take a look if you want. but without symptoms [shortness of breath, chest pain, radiating sharp pains to the chest/ shoulder/ arms and rarely to other places, murmurs, or abnormal blood work [cardiac enzymes increase]. most 'abnormal' EKGs are normal hence your physicians relative calm.

hope that helps,

TurboJets Only

rhov
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Old 16th Aug 2006, 05:00   #15 (permalink)
 
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rhov,
thank you for your opinion. I will PM you.
185.
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Old 27th Aug 2006, 01:32   #16 (permalink)
 
Join Date: Oct 2003
Location: -26.412, 146.262
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Stress ECG and Echo card completed. All OK.
Sinus node overcomes the VEC's under stress.

no other underlying problems. should have class 1 extended to the usual length forthwith.

phew!
185.
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Old 21st Nov 2006, 14:10   #17 (permalink)
 
Join Date: Apr 2006
Location: Canada
Age: 38
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Quote:
Originally Posted by rhovsquared View Post
T- wave inversion in the inferior lead aVF or III, as was mentioned in the absence of symptomology, and cardiac enzymes Troponin C and such, is generally physiologic, in fact many normal individuals present with tachyarrythmias, bradyarrythmias, and ST segment and T- wave inversion, axis deviaions and even runs of V-fib yet there's no EKG to continuously monitor them. if you don't pass after a retest you may require electrphysiology testing 'cath lab' to completely rule out pathology---a bit ridiculous with out angina or cardiomyopathy--- at least for the non flying

edited to add inferior is lead III... forgot an I
I'm going through the exact same thing now. My EKG showed "nonspecific inferior T abnormalities". The doc said I had a flattened T-wave. I did a stress test and everything came back normal but the t-wave abnormality was still there. Next is the echo. I have no chest pain or symptoms of heart problems. Were you given a reason why your t-waves were "abnormal" on the ekg? My doc said it could just be how my ekg is. If you have any further insight, please feel free to post. As you can imangine I am quite nervous about this!
Thanks
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Old 23rd Nov 2006, 17:34   #18 (permalink)
 
Join Date: Jan 2006
Location: Chester
Posts: 123
Unhappy Heart murmur

I recently went to USA to get my ppl, but when I had my FAA medical done (class 3) the doctor spent ages listening to my heart and then said to me, "Do you know you have a heart murmur?". I said no I didn't and that I hold a Class 1 CAA medical. I nearly asked if he had his stethoscope the right way round! I was horrified, I thought I was going to die. To cut a long story short when I got back to UK I had to have a ECG (normal), blood tests (normal), chest x-ray (normal) and I am now waiting to have an ultra-sound done 21 December. I am really worried about what they are going to find. I spoke to a locum at my surgery who booked all the tests and I asked what the murmur means, and if it means that I will no longer be able to fly. He said that if it is a 'functional sound' (ie. blood sloshing round) then it would be ok, but if it is a sound due to one of my valves then it's not so good ... great. But whatever happens I will have to take anti-biotics if ever I have dental work done.

Is/has anyone been in the same situation as me?
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Old 23rd Nov 2006, 22:20   #19 (permalink)
 
Join Date: Oct 2006
Location: Hong Kong
Posts: 96
Dont worry

About 10 years back (must have been 33 then), after the ECG part of my Class 1, I was told I had an abnormal T wave ( Flat I think ), they granted my Class 1 and I underwent a stress ECG a month later as requested. Jogged on the treadmill for ten mins and got the all clear at the end.

At my next Medical I asked how was the T wave, thankfully there was not a bother on it and it never reared its head since. Dont worry needlessly about requests for extra tests. I was worried when I came to Hong Kong to fly, because their initial medical is a tough cookie, but there was no problems. Relax.
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