Abnormal ECG

[pitchtrim]

Hi All,

A Recent medical reported 'minor abnormalilty' on the ECG requiring further investigation with either a CAA cardiologist or a private consultant.

Has anyone got any thoughts surrounding the pro's and cons of going to the CAA or Private?

Also, can anyone shed a little info on what I'm likely to expect?

I'm a generally healthy 40yr male, never smoked, occasionally drink, but haven't exercised much in the last 2 years. The problem surrounds Q/QS waves (I've no idea what this means) and is described as unlikely to represent a significant health problem.

However, I'm a tad worried that my current position in the LHS of a nice shiney regional jet may be in jepoardy.

Anyone got any advice?

[QDMQDMQDM]

Do you know the actual ECG abnormality? It's hard to comment without knowing that.

Dunno about private or CAA. I guess that if you got a private one and then get an opinion you don't like you can go on to another private one rapidly before alarm bells ring.

QDM

[pitchtrim]

Hi QDM,

No specific problem was stated, just that Q/Qs waves were inferior !

I actually found a a 4 year old ECG trace in some old med records and there is a slight difference between it and the present one on the the trace marked III. The wave drops slightly below the ref (horizontal) line whereas on the 4 year old one most of the variation appears above the line. Is this the Q/QS wave I wonder?

I really don't have any idea what I'm looking at so I'm trying not to read too much into it.

cheers

[QDMQDMQDM]

This is third-hand diagnosis by a GP of an ECG he's never seen. The flying analogy would be a flexwing microlight pilot with experience of MS Flightsim, shooting an approach into the old Kai Tak in a 747 via telemetry, so take what you read with a large pinch of salt, but...

It's sounding a little like you have an isolated Q wave in lead III. As you can see from the link this is not likely to be significant in the absence of symptoms or other ECG changes:

http://www.madsci.com/manu/ekg_qwav.htm

Better get it checked out though!

Good luck,

QDM

[pitchtrim]

Hi QDM,

Appreciate what your saying about a 3rd hand diagnosis, i realise there are so many variables it must be nigh on impossible to come up with an answer on the details I've given so far!

Thanks for trying anyway. The link looks fascinating and makes this flying lark look positively easy in comparision.

Well I certainly don't feel unwell, so thats a good start eh?

thanks

pitchtrim

[QDMQDMQDM]

Well I certainly don't feel unwell, so thats a good start eh?

Yep. My gut feeling, for what it's worth, is that this won't turn out to be anything significant.

Best of luck,

QDM

[Captain Airclues]

pitchtrim

If you search on this forum you will find desciptions of the procedures.

I would recommend going to the CAA. I found them to be very fair, and it's free. You will probably have to walk on their treadmill so it's worth going to the gym, if only to get the legs up to strength. I did 14 minutes at up to 16 degrees before they gave up and sent me home with the full medical (I had ectopic beats).

Whatever you decide, I wish you luck. The apprehension is worse than the actual experience.

Airclues

[pitchtrim]

Guys,

Just got back from a busy week.

Thanks for the tips.

I've been given a few weeks notice to get checked out so I'm doing all that is practical to ensure I come out on top.

Cutting down on the surplus calories, plus I've started swimming again. I still feel fine!

Thanks again.

[AhhhVC813]

As with Captain Airclues went to CAA; T wave trouble, eventually decided not to pay for a private consultation and went to Gatwick. They are helpful, understanding and will make you feel comfortable. I got the impression through my and other peoples experiences, that they are not trying to pull your licence, just checking an anomaly. Hope all goes well.

[pitchtrim]

Guys, Thanks for your comments, I thought I'd let you know the outcome.

As suspected it was nothing to worry about. What a relief

I decided to go to the CAA at Gatwick and, I too found them very helpful.

The problems in my case (for the more medically minded) appeared to be one of interpreting measurements. As mentioned above, it would seem that none of the tests are to be taken individually and a specialist takes every thing into account to get the full picture.

The BP readings previously thought to be approaching the high side was put down to the arm cuff being to small for my arm! A larger cuff gave a 120/80 reading.

The unwanted negative blip (in very laymen like terms!) on the ecg trace came down to the electrode picking up activity on the opposite site of the heart to that intended. Something to do with the heart orientation etc.

Either way, the time on the treadmill was easy compared to the gym/pool so I was given clean bill of health. :D

cheers.

[QDMQDMQDM]

Thanks for letting us know. What a relief for you!

Happy Flying,

QDM

[PSYCOBFH]

Guys,

How long was it before
a.) you were written to by the CAA to inform you of a 'problem' with the ECG requiring further investigation, &
b.) how long after that were you able to get an appointment to see their cardiologist - did they make you wait weeks/months, or were they fairly snappy about getting you in.

And finally, how did they actually treat you , ie, were they sympathetic or were they very business like and abrupt- I've never had any dealings with them before.


thanks

[southflyer]

Greetings,

Would anyone like to comment on this issue?

I recently had an ECG performed as I got my last physical at age 35. The computer printout/report came with the folowing diagnosis:

"Borderline ECG, irregular sinus bradycardia, extensive ST elevation, consider pericarditis."

I then had another ECG performed:

"Borderline normal, sinus rhythm, early repolarization"

I then had an echocardiographic examination which was evaluated as normal buy my cardiologist.

I am 35 years old, run 5 miles/day, healthy, don't smoke, drink socially. All the feedback I have received from my doctors on this "supposedly" abnormal ECG is that there is nothing wrong with my heart or health, that the "abnormality" in my ECGs is a result of all the exercise I do. However, I would like some input from an aviation point of view, i.e., would this condition pose a problem in the future for getting a 1st Class Medical and/or with an airline's medical department??

Any comments are highly appreciated!

Best regards,

[pitchtrim]

Hi PSYCOBFH

In my case I the CAA med dept wrote to me within about 3weeks of the medical.

I was given two months to visit a cardiologist, either independant or at at CAA. I'm sure this would vary depending on the perceived problem. I asked for an appointment about 6 weeks down the line and it was'nt a problem.

I considered my options and eventually decided to go to the CAA, the treatment was excellent. (and free!) I found the team helpful and the consultant I saw very quickly put me at ease dispelling any mis conceptions of the CAA being out to pull my licence.

Obviously much depends on the individual problem, but visiting the CAA med dept was nothing to worry about.

cheers

[PSYCOBFH]

Pitchtrim,

Thanks for that. Did they tell you what the problem was, so that you could go, informed, to a cardiologist?
Like you, I will probably use the CAA med dept. that way at least you are dealing with aviation/licensing experts. My main concern was one of being treated as having failed the ECG and having to prove myself. From what you have said, they put you at ease which must have been a huge help in itself.

cheers,

[slim_slag]

Not sure whether I agree with the concept of "failing an ecg" because of a computer interpretation. These computers are pretty good, sometimes better then a lot of non-cardiologists and that is very useful, but at the end of the day an ecg is only a single piece of evidence for the skilled physician, it often does not show the whole picture. I'd certainly be pretty amazed if a doctor disqualified you from flying for a living because the computer said your ecg was 'borderline normal'.

More important is that you now have a baseline ecg. Quite often the physician will look at a recent ecg and be scratching his head, and wish he had something from a week/month/day/hour ago. It's changes which count a lot, your "normal" ecg may look a bit weird but there is nothing wrong with you. Sometimes you can have a normal ecg and on walking of of the door you drop dead of an arrythmia.

I remember handing a group of medical students an ecg, but I'd taken out the computer diagnosis. Was some time ago, back in the days the computer would throw out some real funnies. Half of the students didn't even know which way up it should be. Good things these computers, but they are damaging the 'art'. Looking at some of the threads in the professional forum, it appears the same thing is happening in flying jets.

[QDMQDMQDM]

I thought I'd already answered this one, but I don't know where the answer has disappeared to. Anyway, this just sounds like a normal ECG and an over-zealous computer interpretation. Get checked out, but don't sweat too much, is my advice.

QDM

[pitchtrim]

Hi PSYCOBFH,

The original letter gave no indication of the exact (or perceived) problem. It was put simply as an anomaly that needed investigation. Given that I had two months to get checked out I re assured myself it could'nt be too bad otherwise I would have been stopped from flying immedately.

During the consultation a comprehensive explanation of the results was given, it was very helpful.

I got the impression these guys would do all they could to help and that withdrawing a medical really is the last resort.

cheers

[homesick rae]

i had been getting pretty severe eptopic beats, which began when i received some bad news( no joke here )...

1st ECG the doc did a couple of blood tests to make sure on something and gave me the all clear and said it was "probably stress related"

the problem still remained but not as alarming and i had another ECG with a different clinic a couple of years later..."minor abnormalities"...blood tests showed high cholestrol, triglycerides etc etc...was put on statins and plavix which scared the #### out of me...

i felt fine, had no probs at all, exercising...the pills of course ran out...and i carried on as normal...

had another ECG last year which was normal and the doc said there were "no alarm bells ringing"...i explained one sudden jolt of pain in my chest one day when walking, but also told him i played tennis later that evening...the odd ache appears now and again, but again he said it was nothing to worry about! he mentioned thati may have ventricular irregularities which a lot of people have and that i just have to get on with life and try to ignore it!

slightly digressing here i know but in the same category i guess!

any comments!