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Forum Name: Ischemic Heart Disease

Question: Septal Infarct EKG for a pre-op clearance


 nursekelly83 - Thu Jan 04, 2007 7:47 pm

I'm a 23 year old female. I am obese and have GERD. I have a family history of DMII, HTN, Hyperlipid, CA.
I just had pre-op testing performed yesterday. I'm scheduled to undergo Gastric Bypass Surgery next Thursday 1/11/07. I received a call today from my surgeon's office stating that my EKG was abnormal and I needed a cardiac clearance. I work in a clinic, so one of the Internests there ordered another EKG on me, they also retrieved an EKG that was done pre-op for my gallbladder surgery in January of 2002. The EKG from 2002 and the EKG from today we practically identical. They both stated "Normal Sinus Rythm, Septal Infarct Age Undetermined, Abnormal ECG" I have 2 questions.
1) Am I stable to undergo surgery if the previous EKG was in 2002 and there have been no changes in it. (In which I've also had GallBladder Surgery and Back Surgery since that EKG)

2) What exactly does it mean? I mean it's obviously a correct diagnoses if 3 different EKGs show it. I mean, is there anything I can do, will losing weight help that? Thank you very much for your time. :)
 John Kenyon, CNA - Thu Jan 04, 2007 11:18 pm

User avatar Hello nursekelly83 - There are a number of things here that can be addressed: first, each EKG needs to be read, even though what the machine "sees" and prints on it is the same, because there can be changes withiin certain parameters. However, it seems likely that since you were OK'd for surgeries in the past with the same finding, and you are rather young, it's likely you will be given the green light again. And there may be a good reason for this other than what the EKG machines have picked up: in obese females (and even some who are simply short of stature) it is sometimes very difficult to get a "normal" reading because of anatomic variations, especially in the distances between "landmarks" and the thickness of fatty tissue. So the "old septal infarct" may well be only an artifact. Apparently no doctor has ever urged you to investigate further, and this may be why. The EKG may actually be normal, and the only way for that to be made official is for it to be read by an MD. The machines we have now will not accept a variant without putting a label on it, so it's a good thing a doctor has to read and sign off before the actual finding goes in your chart.

You do have some familial factors which could be significantly reduced via the planned surgery and reduce your risk of a future coronary event, which makes it more likely you will get cleared for it. Meanwhile, to answer your bottom-line question, an MD will have to actually read the newest EKG, compare it with the older one, and make the call. There's no way around that, but I suspect it won't matter, as the reading of the machine is likely just artifact.

Good luck to you. This is an important step in protecting your health.

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