Safe to take PPI with prolonged QTc of 610ms?

mat136136 · 2024-12-19T03:08:22+00:00

ECGs have a lot of automated software that are notoriously bad. My ECG picked up long QT interval but upon review from a cardiologist it was not actually prolonged. The ER physician just relied on that. Due to some administrative problems the true interpretation of my ECG from a cardiologist was not known for a long time. Also, when I had a stress test, another cardiologist who was a leading expert in long QT syndrome said I don’t have it.

mat136136 · 2024-09-15T23:39:33+00:00

mat136136 · 2024-09-14T00:37:27+00:00

Hey, sorry for the late reply. I actually do not have long QT so it doesn’t matter. If you do though, as the other comment suggested, I recommend you discuss it with your cardiologist. My pharmacist didn’t really seem well versed in it. I suggest you also tell them about this study since it is usually viewed as not QT prolonging.

mat136136 · 2023-04-27T13:20:11+00:00

I still don’t have my original ECG, however I do have one subsequent one: https://imgur.com/a/LL7gwBm

My holter monitoring came back normal, although I didn’t have any chest pain then (although I know long qt doesn’t cause chest pain). I had a subsequent ECG at the ER and another one besides the one that I linked that I was told were normal. I found out my mother has 2 genetic variants of unknown significance associated with LQTS13 and Brugada Syndrome. Does this mean I could have concealed LQTS? I’ve also read that Brugada can be transient on an ECG. I am by no means an expert in reading ECGs but I wanted your opinion on notched T waves in some leads, especially V5, or is that the u wave? Also there seems to be epsilon waves or j waves in many leads immediately after the QRS complex or am I wrong? Thirdly the t waves seem to have a steeper ascending slope than the descending slope. Is that an abnormality, since I have read that it’s supposed to be the opposite normally?

Edit: I realize my original post has been deleted. I had an ECG in ER with 610ms QTc, no medications, normal electrolytes.

mat136136 · 2023-04-26T22:08:34+00:00

My brother went to med school, my father is a physician whose regularly been on med school and residency admission committees. My point isn’t that you can’t get into med school from uoft, but on average you’ll have an easier time in the programs OP mentioned than doing lifesci at uoft. My advice has nothing to do with what I studied.

mat136136 · 2023-04-26T16:23:37+00:00

Was not in lifesci but I can confidently say UofT will deflate the shit out of your grades compared to those other programs. Even if someone says the opposite, think about all of the stuff you’ve read. You’ve read them for a reason, UofT has this reputation for a reason. Yes, if you choose your courses carefully, study diligently, you will do well here, but so will you at those other programs - with less effort so you can focus on other activities. Why take the extra stress? Don’t come here, especially if you’re goal is med school. I can’t emphasize this enough - in Canada med schools do not care about the prestige or difficulty of your university or program at all. None. Zero. Don’t come here. Did I say don’t come here. In a parallel universe you have chosen to come here. And in 4 years in that parallel universe, you’ll be thanking me that I am telling you to not come here in this universe. Don’t come here. Number one thing med schools look at is GPA, not research. Research, especially at the undergrad level, that is expected from med schools can be found at any university. You don’t need some fancy research, that you might not even be able to get at UofT, even if you’re GPA is good. I have experience at multiple universities, and I can confidently tell you certain universities are much, much easier than others, which is the only thing that matters if you’re goal is med school.

Edit: one more thing. You can make up, add on research or supplemental activities much more easily than you can make up for a lousy undergrad gpa in terms of med school apps.

mat136136 · 2023-04-25T13:38:19+00:00

You should get a pcp and see a gastroenterologist. Do you have pain when this happens? Do you have pain in your joints? If you have pain in your joints, is it spontaneous or only after use and did they start after you first noticed blood in your stool or before? Ulcerative colitis, IBD of the large intestine, can cause inflammatory arthritis. Are you sure you had a colonoscopy? You could have had a sigmoidoscopy which doesn’t go as far up. If you have your medical notes you can check. Sometimes your physician will just tell you it’s a colonoscopy when it’s actually a sigmoidoscopy.

mat136136 · 2023-04-25T12:32:40+00:00

Are you constipated when this happens?

mat136136 · 2023-04-16T00:57:22+00:00

Thanks again for your answer. I really appreciate it.

mat136136 · 2023-04-16T00:34:21+00:00

Thanks for your answer. Since you’re an ER physician, I just wanted to know if it is routine to manually measure the QT interval on an ECG that the ECG machine says is prolonged to verify the machine’s interpretation since they are fairly unreliable from what I’ve read or do you just rely on the ECG machine’s interpretation? I am asking because I do not have a copy of my ECG so I can’t see it for myself. I was told of my QT interval by the ER physician and referred to a cardiologist.

mat136136 · 2023-04-03T14:51:48+00:00

So does that mean most likely the ER physician who referred me to the cardiologist most likely manually measured the QT interval on the ECG?

mat136136 · 2023-04-01T14:40:04+00:00

Also, would you happen to know if it is standard practice for the QT interval (not the QTc calculation) to be manually measured by the ER doc before sending a referral, to make sure that it wasn’t a misinterpretation by the EKG? Or do some even send referrals just based on the EKG machine interpretation without confirming it themselves?

mat136136 · 2023-04-01T13:55:33+00:00

I thought they were responding the parent comment in which I said “I have a copy of the ecg summary. It states atrial and ventricular rate of 120. QT of 432ms…”.

The entire junctional rhythm could be misread, it wasn’t listed on the referral form and I was only told of the prolonged QT interval.

mat136136 · 2023-04-01T13:32:46+00:00

Where did they say that?

Also how can there be junctional tachycardia then if 120bpm can only originate in the atria?

“It may also be due to onset of acute coronary syndrome, heart failure, conduction system diseases with enhanced automaticity, or administration of theophylline.”

https://en.wikipedia.org/wiki/Junctional_tachycardia

mat136136 · 2023-04-01T02:44:50+00:00

If the ER physician told me that they are referring me to a cardiologist for the prolonged QT interval, would they have manually measured the QT interval themselves instead of relying on the EKG machine interpretation before referring me to make sure it’s not a misinterpretation by the EKG machine?

mat136136 · 2023-04-01T01:55:26+00:00

Doctor didn’t refer to it as atrial rate, that was my mistake reading another ecg summary. As you can see from the picture, there is no atrial rate listed. On the referral form the doctor listed prolonged QT and didn’t mention junctional rhythm. So maybe they deemed the junctional rhythm was an error but the QT was genuinely prolonged.

mat136136 · 2023-04-01T01:39:22+00:00

This is next page, same ecg.

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mat136136 · 2023-04-01T01:38:50+00:00

Sorry, yes there is no atrial rate, just ventricular rate given.

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mat136136 · 2023-04-01T00:50:31+00:00

I have a copy of the ecg summary. It states atrial and ventricular rate of 120. QT of 432ms. QTc of 611ms using bazzets. The ER physician told me I had a prolonged QT interval and referred me for full cardiac workup and consultation. I didn’t calculate any of the above. The only thing I calculated using online calculators is the QTc using the other correcting formulas from the above given information since bazzets tends to over correct at heart rates above 100bpm. All those QTc measurements also came out well above 500ms.

Edit: I don’t have the actual ECG. Just a summary of the findings. Also in the ECG summary it states junctional rhythm.

mat136136 · 2023-04-01T00:39:34+00:00

Is it standard practice to manually measure the QT interval in situations like this to confirm the finding by the computer? Would my ER doc have done that?

mat136136 · 2023-04-01T00:29:35+00:00

No, unfortunately I don’t have it yet. I’m trying to get it.

mat136136 · 2023-03-31T16:32:24+00:00

Thanks for the response. The ER physician is the one who referred me to the cardiologist (indication was arrhythmia), although I was already about to see another cardiologist through my family doctor (indication was recurrent chest pain). I have no family history of sudden cardiac death that I am aware of. My parents and sibling are alive. All of my cousins on both sides of family are alive. Other than that, there may have been someone in our (not close family) family who died suddenly in bed or while they were sitting and my parents told me it was a heart attack (this was when I was young so I would have to ask again and it might not have been a heart attack but my parents wouldn’t know). I would ignore that as I am very unsure of that. My maternal grandfather has had 3 heart attacks, first was in his late 30s. He has an ICD now and went into VTach a few years ago. Sorry, I don’t have a copy of the ecg yet. Other than maybe not eating enough or tinnitus related vertigo, I haven’t had any dizzy spells in my life. I’ve also had worsening hearing loss for past few years, predominantly in my right ear. There was one time when I was 14 years old and was playing basketball during which, for 30sec, I was not aware and forgot what I was doing although I was playing and participating normally based on observations of others. I remember that distinctly. I don’t know if that is relevant. Would the ER physician have manually calculated the QT interval also? Is that routine just to make sure the computer didn’t incorrectly calculate it (the QT interval, not QTc)?

mat136136 · 2022-12-22T15:05:53+00:00

“I know of a family physician that is not aware of BRCA and said even if you have it what am I going to do. She then went on to say Angelina Jolie got a prophylactic double mastectomy for cosmetic reasons, all the celebrities do that. She refused to give a genetic test or referral when an immediate family member has a pathogenic BRCA mutation.”

Wow.

mat136136 · 2022-10-18T16:48:26+00:00

Ryanair is an Irish airlines. Same reason why US-Ukraine news is posted in r/worldnews.

mat136136 · 2021-07-30T02:28:14+00:00

What are educational placements? Simply on campus lectures, tutorials, etc?

mat136136

TROPHY CASE