Understanding Abnormal ECG Results Before Surgery

Understanding Abnormal ECG Readings Before Surgery

An electrocardiogram (ECG or EKG) test is commonly performed before undergoing surgery. It records the hearts electrical signals and can detect abnormalities. If you receive abnormal ECG results before surgery, its natural to feel worried, but most readings outside the norm turn out to be benign.

Why ECGs Are Performed Before Surgery

Doctors use ECGs before surgery to:

• Establish a baseline of your heart health
• Uncover conditions like arrhythmias, heart attacks, heart disease, and congenital heart defects
• Assess how your heart might withstand anesthesia and surgery
• Diagnose issues that may require postponing the procedure

Catching new or previously undiagnosed heart problems allows steps to stabilize conditions beforehand when possible.

Reading & Interpreting Abnormal ECG Results

ECG reports require careful analysis and interpretation. Doctors compare findings like wave patterns, distances between waves on complexes, durations of electrical activities, and heart rate to reference standards.

When any measurement falls outside expected values, it may warrant further examination to determine the cause and whether treatment is needed.

Understanding Common Terminology

Below are some key terms used to describe ECG findings:

• Dysrhythmia: Irregular heartbeat pattern
• Arrythmia: Abnormal heart rhythm
• Ectopic: Earlier or extra heartbeat
• Aberrant: Abnormal conduction of heartbeat
• Heart block: Delayed conduction between chambers

These and other technical words describe abnormalities on an ECG report. Their exact meaning requires correlation with clinical symptoms.

Evaluating the Severity of Abnormal ECG Results

Not every ECG irregularity poses an imminent health threat or contradicts surgery. Cardiologists determine severity based on:

Specific Type of Abnormality

Benign changes like a slightly prolonged QT interval are less concerning than a new complete heart block or sustained ventricular tachycardia associated with symptoms.

Presence & Severity of Symptoms

Signs like dizziness, shortness of breath, palpitations, or chest pain alongside ECG abnormalities warrant more investigation compared to no symptoms.

Medical History & Related Diagnoses

For example, newly discovered atrial fibrillation signals greater risk in older patients with a history of strokes compared to lone irregularity in an otherwise young, healthy person.

Possibility of Underlying Conditions

Doctors determine if abnormalities may be explained by electrolyte imbalances, hormonal disorders, side effects of medications, recreational drug use, underlying lung disease, genetic syndromes, or undiagnosed problems requiring treatment before an elective surgery.

Common Abnormal ECG Findings Before Surgery

Below are examples of some frequent abnormal preoperative ECG results:

Left Bundle Branch Block (LBBB)

LBBB means delayed conduction between the left and right ventricles. Many cases are benign, but LBBB can sometimes indicate underlying disease like cardiomyopathy requiring further assessment before surgery.

Right Bundle Branch Block (RBBB)

Like LBBB, RBBB reflects disrupted electrical signal flow within the heart. Theres an association between RBBB and pulmonary issues like blood clots in lung arteries, requiring closer review.

Atrial Fibrillation (AFib)

AFib shows up as a totally irregular rhythm caused by erratic electrical impulses in the hearts upper chambers. Patients may need medications or cardioversion before surgery if symptoms are present.

Premature Ventricular Contractions (PVCs)

PVCs are extra, early heartbeats originating in a ventricle rather than the sinoatrial node. Theyre very common and typically benign, but frequent PVCs will be further evaluated.

First-Degree Heart Block

First-degree heart block refers to a slightly delayed signal between the sinoatrial and atrioventricular nodes. It usually does not affect surgery clearance unless other signs of conduction disease exist.

Long QT Interval

A prolonged QT interval may predispose some patients to dangerous fast heart rhythms. Repeat ECGs help determine if the finding is congenital or acquired.

Left Ventricular Hypertrophy (LVH)

ECGs can detect LVH, an enlarging of the hearts main pumping chamber. It develops in response to conditions like uncontrolled high blood pressure over many years.

Determining Surgery Eligibility After an Abnormal ECG

Cardiologists decide if abnormal ECG results require postponing or canceling elective surgery based on an estimate of perioperative cardiac risk.

Heart Team Approach

Collaboration between cardiologists, anesthesiologists, surgeons and primary doctors results in the safest care plan. Open communication ensures all specialists have the patients full medical history for context.

Additional Cardiac Testing

To clarify ECG findings, doctors may order echocardiograms, exercise stress testing, CT coronary angiograms, or two-week cardiac event monitors. This helps stratify surgical risk more accurately.

Evaluating Benefits vs. Risks

The necessity of surgery is weighed against potential heart complications. Doctors assess if alternatives like watchful waiting, medications, or nonsurgical procedures are appropriate.

Optimizing Conditions Before Surgery

Steps may include managing heart failure, regulating thyroid levels, supplementing electrolytes, altering medications, controlling blood pressure, and more based on the ECG results.

Careful Monitoring During & After Surgery

If surgery proceeds, abnormal ECG findings alert anesthesiology and recovery teams for vigilant monitoring of heart rhythms, blood pressures, and oxygen levels.

Preoperative Abnormal ECGs: Reason for Hope

Try not to panic over abnormal preoperative ECG reports. In most cases, subsequent evaluation and clarification from cardiologists reveal no imminent threats.

Even some findings once considered too high-risk for surgery can now be carefully managed with proper precautions and planning. Focus on open communication with your care team and following recommended treatment instructions.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.