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ECG abnormal indication

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ECG abnormal indication

Old 28th Feb 2013, 15:34
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ECG abnormal indication

Dear Fellows,

Had an ECG taken yesterday, and it showed a Depression segment ST-1mm along with sinus tachycardia
I did the test just a week before my annual First class medical renewal (in London) in order to make sure I don't get any surprises during my visit to AME.
I can understand the tachycardia, since my pulse always get running the moment I lay down for an ECG, however the other abnormality totally shocked me. First I thought that it is bad wiring, so I did another ECG the following morning. Same thing

I couldn't sleep the night, just thinking of what if I get grounded and all the bad stuff...

I haven't experienced any chest pain or another symptoms. I am 34 year old, non smoker and I don't drink. I am 173sm tall and my weight is 62 kg.

Has any of you had a similar condition on a ECG? I am not sure whether I should go ahead and take the First class medical renewal test or shall I first talk to cardiologist?


Any suggestions are greatly appreciated!
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Old 1st Mar 2013, 08:20
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Go to another Doctor - was told recently, after an ECG with a top UK Cardiologist, that I had had a heart attack with permanent damage. Long story short I didn't.

Quack - too many toys some of them !

Last edited by Good Business Sense; 1st Mar 2013 at 08:21.
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Old 1st Mar 2013, 08:38
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This has come up before

An ECG is no different from any other medical test. The results need to be analysed by a doctor or healthcare worker who is qualified to do so. The problem with ECGs is that the manufacturer adds in a small algorithm that prints out a list of basic diagnoses based on basic parameters. Some are correct, others are not. Many many ECGs report abnormalities

I would suggest you ask the doctor who undertook your ECG to read it and advise you. However given that you cannot modify your ECG there seems little point in spending time and money on it before your medical

Tachycardia merely means a fast pulse which you can measure with your finger on your wrist. It goes up with exercise and fear and falls at rest. If your resting rate is under 80 and you are otherwise well I would not worry

A minor ST depression again is not alarming. The minimum the machine can measure is 1 mm and in general we ignore this. It need to be bigger but we also need to know which leads it can be seen in and the shape of the ST segment

Hope this helps. Let us know how you get on
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Old 1st Mar 2013, 09:42
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Many thanks for the reply.
My pulse is in the range of 70-80 bpm .However as soon as I step in a doctor's office it starts jumping. I was told that this is the "white coat syndrome" and it will gets even worse with age.. You can't train for it,you can do nothing


However given that you cannot modify your ECG there seems little point in spending time and money on it before your medical
Now that is my biggest concern! If AME sees the abnormality,he will refer to a cardiologist afterwards .And if God forbid my condition is something which is not allowed for the pilots certificate,that would mean an end to a career.
I've been reading lately that Depresion segment ST might be an indication of a Ischemic heart desease, and that scared the hell out me! As far as I know a person with an IHD is considered unfit by EASA... I hear gettin a medical certificate once you were considered unfit is a bureaucratic nightmare..

The doctor who performed the ECG said ,that I would need to take additional test such as a Holter Monitor and a Echocardiogram and only after that a say for sure what's wrong or not. I will be taking these tests next week. Hope everything to be normal.

I guess ,I was wrong thinking, that maybe if I see a cardiologist first and take some medicine I might get back to the normal ECG before going to a pilots medical?

I am still confused what to do...
Many thanks again for the kind replies.
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Old 1st Mar 2013, 11:12
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I hope all is ok for you ! You nevertheless bring up a valid point that that is fairly unique to flying.
Very few careers can be cut short by having to pass a medical every year!
How would a Doctor, Lawyer, Banker feel if every year they had to go for a medical knowing that they could come out of that surgery as an Ex Doctor, Lawyer, Banker!

No wonder so many pilots have racing hearts, raised BP ( forget white coat it's loss of livelihood career syndrome)

No wonder so many cover up concerns by avoiding taking problems to GPs but ignore symptoms until its too late with a stick head in the sand attitude.

Good luck anyway I would put money on it that in your case all will be fine

Last edited by Pace; 1st Mar 2013 at 11:33.
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Old 1st Mar 2013, 15:58
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Pace

Most men ignore their health, not just pilots. Pilots as a population are above average on health.

GS capture

I am not supposed to criticise other doctors, but based on what I know I would advise you not to have any further tests

When you have your aviation ECG your AME will send it to Gatwick where it will be read by a human not a machine. The rate is irrelevant unless your AME is worried.

At your age I strongly suspect the ST depression is nonsense. If you do not have chest pain or shortness of breath please just go have your medical and tell us how you get on
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Old 2nd Mar 2013, 09:11
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homonculus
Thank you for your advice Doc ! I will probably go to a AME, however it would not be the same going there, when you were told,that you need further evaluation of you heart. I do not know ,whether it is psychological or not,but right after that ECG and on the following day, I started feeling minor chest discomfort. I am not sure whether this is because I am not active and sit down in front of a PC reading a medical stuff,that I know will mess up my mind or it is just my imagination. Maybe I am being hypochondriac,but just as Pace said,we pilots really care about the outcome of our medicals. And the reason not to visit doctor's office that often is because we fear to hear ,that something might be wrong and we could be grounded. On another hand I understand how silly this statement might sound to the doctors ,and that's why I am going to get this check up done no matter whether I get my pilots medical or not.

As a corporate pilot who, doesn't fly much,but spends most of the time away from home in a hotel room or an apartment I really need to start exercise more regularly. But I guess, first I need to know whether my heart is healthy enough for this.

Again ,homonculus and Pace, thank you very much for the support and kind comments. I feel much better when I speak about it with someone.

Cheers,
I will keep you posted.
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Old 2nd Mar 2013, 10:54
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GS

I am not medically qualified just a pilot who has always been interested in things medical ; )
It does sound like you have panicked yourself and obsessed over this ?
That alone anxiety can cause a tight chest. Muscular aches, shallow breathing, dizziness, racing heart etc.
I would take a medically qualified opinion given by Homonculus and do nothing till your medical!
Also keep off googling on the computer and scaring yourself silly!
As stated and this is only instinct I would put money on it that there is nothing wrong!
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Old 4th Mar 2013, 17:54
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Smile Abnormal ECG

I think that Homunculus has already given you a good overview, and I would agree that a 1mm. change in the ST segment is hardly proof of any major problems with your heart, particularly given your age, height, weight and non-smoking history. In giving advice about this, I always try to put myself in the same dilemma and ask myself what I would do. In this case, I would go ahead with the renewal. Your ECG will then be sent to Gatwick where it will be scrutinised by a cardiologist with wide experience of Aviation Cardiology. If he is happy with it, then that's all that will happen. If he has doubts, you will be asked to have an effort ECG, and if there is a problem, then the ST shift will become more marked, and further investigations could be called for. ECG changes are not uncommon, and most of them turn out to be completely benign, so stay cool!
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Old 4th Mar 2013, 20:42
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The machines are generally up.

If I performed an ecg on all the patients in the waiting room, then about 75% would be shown to have an abnormality. If I looked deep enough (incorporating some blood tests etc), then I reckon I could find something "wrong" with most of 'em.

You need a human to separate the wheat from the chaff.

Your history (the story you tell of your symptoms) is uneventful.

I'm not clear why the authorities continue to perform resting ecg's. There is no correlation between performing ecg's and planes falling out of the sky.
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Old 4th Mar 2013, 22:36
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They do resting ECGs because the rules say so. Much easier to apply the rules than be confused by common sense.
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Old 5th Mar 2013, 09:21
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The CAA is being renamed to "CYA"
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Old 5th Mar 2013, 10:36
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I failed an ECG for Class 1 renewal with an AME - machine said I had an issue (different to yours).

Referred to CAA, human read it, and I got my new medical within 4 days.

Dont waste your money twice.
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Old 10th Mar 2013, 20:44
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GS Capture - any news?
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Old 11th Mar 2013, 16:32
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I've had the exact same issue a couple of years ago during a routine class 1 renewal. My pulse racing away at the doctor lead to a ECG-test which stated I had "sinus tachycardia". It was investigated by the CAA, they ran some tests and I got my medical renewed when they where 100 % it was only due to "white coat syndrome". A few tests to go trough (some samples, 24 hour ECG), but nothing serious. Just relax and you'll be fine!

Last edited by Flux valve; 11th Mar 2013 at 16:33.
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Old 11th Mar 2013, 23:08
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How silly.

Any doctor I know would just feel the pulse an hour later

So readers, please remember sinus means normal and tachycardia means fast. If you are diagnosed with this amazing disease please go and have a cup of coffee and ask your AME to take your pulse or redo the ECG

It is not necessary to do any other tests if your heart rate settles down

Off for a cup of coffee myself now
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Old 12th Mar 2013, 10:07
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Hope it's decaff
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Old 12th Mar 2013, 12:09
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Dear All,

Thanks again for all your support. I had to reschedule my appointment to the AME, due to change in my schedule. Meanwhile I had done the holter test,which stated that everything is within normal limits. This brings some light into the tunel..
I am going for my medical at the end of the month. I will keep you updated!

Cheers

GS Capture
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Old 12th Mar 2013, 21:48
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Normally - people who post their ailments online do so because they are concerned and look for answers. When the problem is resolved to their liking, they almost never return to report their findings - they cheer up and move o in life.
Seems GS Capture is OK perhaps......................
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Old 12th Mar 2013, 22:36
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We believe so TC simply because sinus tachycardia isn't a disease. It is normal!!!! Provided it is not permanent
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