Weird ECG? Need opinions

[akroeze]

So I was fiddling with our MRx, getting used to the different features and stuff. I hooked myself up and ran some strips. This is the first monitor I've used that had more than Lead II so I have no reference. This is what I found. Note the leads, I only saved Lead III from the first time and then I did a repeat and printed all three leads:

http://home.cogeco.ca/~rkroeze/ecg1.jpg

http://home.cogeco.ca/~rkroeze/ecg2.jpg

I apologise for the size of the images/files but the base computer has very limited software

Someone explain the notching in Lead III on the R wave for me? It's especially confusing for me as the amplitude of each peak changes (and even which one is taller changes). I have shown it to partners and they say BBB... is this true? Should I be seeing a doctor? lol

Thanks

[AZCEP]

A bundle branch block would be indicated by a QRS wider than 0.12 sec in a given lead. I don't quite see that happening. On the plus side, you did have the foresight to have your monitor in diagnostic mode, so the information is actually usable.

Lead III looks at an axis roughly 110-120 degrees from Lead I. There should be some differences between the two, and from what is shown, not really anything to get overly excited about yet. If you had lead II, we'd be able to give a rough estimation of your frontal plane axis, but without it, there really isn't anything to say.

Have you had any problems in the past? Current state of health? If you don't have any symptoms, most won't rush to treat anything anyway.

[IN2B8]

Looks like you need to run a 12 lead just to see the whole picture. Then look in lead V1 to see if the deflection is Pos. or Neg. (Pos. = RBBB Neg. = LBBB by Bob Page) and the QRS is greater than 120ms. to see if you have a BBB. This is the best lead to see if you have one, R wave notching is not always the best sign for a BBB.

[akroeze]

A bundle branch block would be indicated by a QRS wider than 0.12 sec in a given lead. I don't quite see that happening. On the plus side, you did have the foresight to have your monitor in diagnostic mode, so the information is actually usable.

Lead III looks at an axis roughly 110-120 degrees from Lead I. There should be some differences between the two, and from what is shown, not really anything to get overly excited about yet. If you had lead II, we'd be able to give a rough estimation of your frontal plane axis, but without it, there really isn't anything to say.

Have you had any problems in the past? Current state of health? If you don't have any symptoms, most won't rush to treat anything anyway.

The first two strips on the second image are Lead II

No real problems, occasionally when exercising (say after 40 push-ups) I get dizzy... but that could just be the exercise. I also have a somewhat higher BP (mid-130s/high-80s) at rest and after said push-ups I wouldn't be surprised to see 150s/100s. O2 sats run anywhere from 94-100%. Resting heart rate varies from 78-92 depending on the time of day. A bit overweight, I'm about 200lbs at 5'10/11

On Losec 20mg BID

I'm 23

As far as a XII Lead, our monitors don't have that ability. I guess what I'm wondering is should I be making an appointment with an MD specifically to discuss this? Or would I wait and just schedule myself in for a physical whenever they can get me in (> 1 month) and ask him to do a baseline XII

[AZCEP]

Obviously, talking to an actual physician that can look at you in person would be the best thing.

I'd not get too excited about this ECG. With the amount of artifact that is in the Lead III strip, the notching could well be due to motion, or any number of other things.

Unless you have some kind of bizarre family history of heart problems, I'd let this go. If it concerns you see your doctor.

[flightmedic608]

Hello, it is not a BBB, more likely 60 cycle interference.

[kelly_isham]

Flightmedic is probably very correct on the 60 cycle interference. Probably in a room with flourescent lights. The notch is nothing to worry about in my opinion. Again any type of exam in person would be better than a bunch of medics over the internet. I'd get a physical whenever you can. Just because everyone should get them. But a BBB should be diagnosed over a 12-lead, not a 3-lead, even in diagnostic mode. And dizzy after 40 push-ups? Are those hella fast push-ups or what? Just messing my man. Take care of your self.

AK Kidd

[AZCEP]

Hello, it is not a BBB, more likely 60 cycle interference.

60 cycle interference does not affect the width of the QRS. Only makes it more challenging to see where it begins and ends.

[sledogg1]

It looks like 60 sec..............turn off radio

1 looks NSR In lead 11

Lead 111 with notches possible boarderline RT BBB need 12 lead plus was pt symtomatic

[Thunderchild145]

Yea, but 60 cycle might be responsible for that notching in the R. Either way, the QRS is less than 120msec, so I'm not apt to diagnose a BBB. I've seen several things that cause R wave notching in cases other than BBB, most of them technical. (Leads on wrong. Old electrodes, and artifact can be blamed for just about anything)