Non-specific T-wave abnormalities and class 1 medicals
 

Hi chaps,

Hoping someone can shed some light and perhaps put my mind at ease (or not!?). Long story short, been flying commercially for 10 years, I'm 35 years old and reasonably fit - I try to run at least a few times a week for between 30mins to 1hr, though of course some weeks are better than others, and do the occasional weights etc. I don't have any symptoms or manifest problems that I am aware of and can happily run 5 miles in 45mins without stopping or becoming too short of breath. 2 years ago I had to do the first ECG in a while (previous to that it was 5 yearly), and it came up with non-specific T-wave abnormalities. AME referred me to a specialist and he recommended that had I not done one previously, I should do an exercise ECG.

I went and did said exercise ECG and there were no signs of the problem. Dr suggested could be positional or otherwise temporary... all signed off and no issue.

Fast forward to now, and I've just had to do my medical renewal with the regular 2 yearly ECG. Once again I have T-wave abnormality and the AME sent off to the specialist again. Just got a reply that "ECG changes have evolved further" and that he is advising a cardiac MRI which I will need to do within the next 2 months.

So not being a medical person, cardiac MRI sounds quite ominous. I do have BUPA for now so hoping to be able to get the costs mostly covered through that and I'm not particularly concerned about dropping dead tomorrow, but is this something I need to be concerned about as regards my future career? As a husband and now also a father to a 1 year old child, the prospect of medical suspensions/loss is more terrifying than previously.

I understand of course that without all the details any advice here will be generic and vague, but would appreciate any input.

Thanks

Given the normal ECG, I am suspicious about how the ECG was undertaken. If the leads are mixed up or incorrectly placed you can get issues. Did you have both ECGs at the same place? If so it might be worth asking your GP to repeat it and to show him the previous ECG.....

I would not be too concerned. The worry with these T waves is that you might have narrowing of your coronary arteries. Not that common at 35......That would result in an abnormal exercise ECG because when you exercise the heart needs more oxygen. If the arteries are narrowed they cant provide it so the ECG gets worse. Yours didnt

Cardiac CT is now the standard often used for undiagnosed chest pain as we can get a 3D picture of these blood vessels rather than an indirect report from an ECG. It is also cheaper than an MRI.

Thanks for the reply.

Yes both the ECGs were taken at the same place 2 years apart. I have been referred to the cardiac MRI by my GP now though he thought it was an over-reaction by the consulting cardiologist... expense isn't really an issue as Bupa are covering it.

I don't have any chest pains or any trouble exercising, so hopefully this MRI will put the issue to bed. Fingers crossed and thanks for the reassurance.

T-wave abnormities are non-specific but could indicate a cardiomyopathy - hence the cardiac MR to assess this.

I had similar issue a couple of years ago with my Class 1 - did a lot of reading of it. I was sent to do ultrasound and they found nothing. What they explained was that (bar misplacement of the electrodes) it is often the case of "athlete's heart" - your heart slightly enlarged due to exercises and the reading of T reflects it. This is actually good but because they go on the safer side they need to investigate further. So apart from additional expenses and time there is nothing to be worried about.

I understand of course that without all the details any advice here will be generic and vague, but would appreciate any input.

Thanks[/QUOTE]..I´ve had a flat / negative T-wave for several years now..Got some extra testing done (holter monitor, MRI, exercise test, ultrasound etc)
and nothing abnormal was found..Still hold a 1st class medical..Recommend kindly that you get your heart checked, that way you will know for sure..
Most likely a normal condition, nothing to be worried about..

Fly safe,
B-757

Update
 

Hi there rusty_y2k2 , hope you are doing great, im having the same abnormal ECG readings I just wanted to ask if you had any update regarding your situation or if you had any issue so far? Cheers

Over here, the Feds are gonna want a Bode Protocol treadmill or a Dobutamine Stress Echo (or some other radiographic stress test)

i wouldn’t sweat it too much

The thread is an old one! Check the date.

There appears to be a new/additional Cardiologist Advisor at the CAA.

Heard plenty of recent stories of a very overly cautious approach and everyone seems to be getting prescribed a Cardiac MRI too !

I wonder if the cautious approach is post the number of reactions to COVID vaccines?