Would you return to the doctor for this ECG result? (Prolonged QT interval)

In My Humble Opinion
1

As a condition of my husband’s continuing employment in Indonesia, our whole family just had thorough check-ups at a local clinic here in Jakarta. In nearly every way I am in good shape - normal weight, cholesterol of 166 (HDL 84, LDL 63), no unusual readings in blood, urine, and stool tests. I’m 52, female, and I run on the treadmill about 4-5km/day on an incline of 6 or 7.

However, my ECG is marked “borderline prolonged QT interval.” (For those familiar with such things, the actual readings were BPM = 60 and QT = 472, for a QTc of 472).

There was no comment from the doctor; the clinic just returned all the filled out forms/completed tests to me so they could be handed in to my husband’s employer. I assume this means that my readings are no cause for concern (especially since they did speak to my husband about his cholesterol level of 202).

At times like this the internet is a mixed blessing. If I combine Google with a healthy dose (heh) of hypochondria, I’m at heightened risk of sudden death. Almost worse, since controlling my stress and my weight are both highly dependent on my exercise regime, is the indication that people with “long QT syndrome” should limit physical activity.

I’m tempted to just take the “la-la-la I can’t hear you” approach and ignore this. I’m not sure speaking to the clinic is a good idea; obviously, they don’t think this is a problem, but if I question them about it, I know exactly what they’ll do - they’ll schedule me for all kinds of expensive tests in Singapore and I’ll wind up paying a fortune and increasing our insurance premiums, almost certainly for no reason.

On the other hand … yes, occasionally my heart does flutter in an out-of-control sort of way in my chest, and I do wake up gasping for breath sometimes, unable to breathe for a moment. Also, while my resting heart rate is good, my heart rate easily goes up to 170 or 180 as soon as I start exercising hard (it comes right down afterward, though).

So, with the understanding that this is just a message board, you can’t give me medical advice, etc. etc. … does anybody have/know anything about this phenomenon? In your humble opinion as a non-professional (or a medical professional who has not examined me), is a reading of 472 in combination with a generally good health profile nothing to worry about? Can I keep on exercising fairly hard? I read that a normal QTc should be 440 or below, but how high does it have to be before you start worrying, or do you start to worry only if people have other conditions like overweight, high cholesterol, etc.

I really, really REALLY don’t want to be a hypochondriac, but I don’t especially trust the doctors here and I don’t want to ignore a potentially serious condition that I could get treated for. Thank you in advance for any comments.

2

I read tons of EKGs, and see them marked as “borderline prolonged QT interval” by the computer doing the interpretation very, very often. And I consider the vast majority of those machine interpretations to be meaningless. EKG interpretation still belongs in the realm of experienced humans, not electronics.

So ask your doc about it. And see if he agrees with the damn machine. And I think calling him to get his opinion is okay.

3

^What he said. Also, remember that “borderline” isn’t the same as “is”. Does it warrant a conversation? Absolutely - *any *time you’re anxious about a lab value, test result or symptom, it warrants a conversation. Do you need to scoot your butt over to the nearest ER, STAT just based on that EKG? No, probably not.

4

As QTM pointed out, EKG reads by the computer are notoriously unreliable (most of the docs I know ignore the computer’s read when looking at an EKG). However, these symptoms could potentially indicate a cardiac issue and I would highly recommend telling your doc that these things happen to you when asking about the EKG result.
A lot of normal people do have the occasional sensation of their heart skipping a beat, so don’t panic just because these things happen to you, but having all the information will help your doctor put the EKG results in the right context.

Also, just because the doctor didn’t say anything at first doesn’t mean that it is not significant. Doctors are human and can sometimes overlook something. Some docs may not be completely up on all the rare syndromes out there. A primary care doc likely doesn’t see Long QT syndrome very often. Heck, my own mother once went to a specialist who totally overlooked that she had indications for a genetic test and then misread the results of the genetic test when telling her about them (they indicated she did have a genetic mutation which was of clinical significance, but the specialist must have looked at the results quickly without realizing what it actually said). Since docs can make mistakes just like any other human, it’s worth it to double check about things you have concerns about.