(Sorry for the long post, and the preamble leading up the actual concerns, but I thought I'd fill in relevant backstory)

Hi again. I posted here a few months back with some concerns over mitral valve regurgitation and echo results. Since then I've been doing fairly well with my life on the whole. Some anxiety, certainly, and sometimes a fair bit, but generally less than when this whole thing started. I may even have been getting used to it.

Although I have what I think are ectopic beats every now and again, I've yet to have a significant run, and may only have a couple every couple days. Compared to many people, I've clearly got it pretty easy. The ectopics themselves don't even scare me all that much anymore.

However, I went it for an appointment with a cardiologist a couple weeks ago that had been booked as a followup to my echocardiogram many months earlier. I wasn't even sure there was much point at the time, but I figured it might be a nice conclusion to the whole thing.

He had a basic EKG and physical exam. Said more or less that I had nothing to worry about, and even told me that he didn't think I had mitral valve regurgitation afterall (despite what the echo report said). Since no physical abnormality of the value was detected, he figured the radiologist administering the exam overcalled it.

Ok, things are more or less fine so far. I was a fair bit more nervous in the following week (I usually have 'aftershocks' of anxiety after being in a medical setting, even if I only get good news, since it reminds me of fears that I haven't been thinking as actively about for a while). Then, without warning, my family doctor calls me in to talk to her.

Turns out that she'd INTENDED to call me in to reassure me, although probably went about it in exactly the wrong way. A call from your doctor out of the blue is kinda unnerving, even if they say it's not urgent. In any case, she read me more or less the full report from the cardiologist that had been forwarded to her, which happens to contain a number of things he never mentioned to me.

Firstly, apparently my EKG in his office showed a right-branch bundle blockage, whatever that is (some sort of electric problem in the heart), although it wasn't considered important without any structural defect. Also, the cardiologist seemed to think my original incident was an episode of ventrical tacycardia, which apparently can cause one to faint among other things.

This seems to be a quite different interpretation of the original episodes than the specialist at the hospital said. For one thing, my pulse only went up to about 120bpm, and I was panicking a bit at the time, anyway. Moreoever, I thought that ectopic beats were quite a different thing than v-tac. I certainly DID have additional spikes visible on my EKG at the time that even I could read, and my feelings of them (like the momentary feeling of loss of breath, or sudden shove from behind) seem consistent with other people's descriptions of them.

I'm wondering what this means? I'd been hoping to put it all behind me, but a different (and apparently somewhat worse?) diganosis of them, which does not agree with the original doctor is a bit of a concern. Also the detection of a definite electrical abnormality is worrisome, despite being told that it isn't. I know I ought to listen when doctors tell me that, and I DO try. And apparently v-tac can actually make one faint, which doesn't sound nearly as benign as ectopics.

I've learned that my family doctor probably isn't very sensitive to anxiety. It's probably not the best idea to tell someone prone to anxiety all the tiny details of their diagnosis, and then more or less cut them loose with very abrupt replies to any anxious questions. I would normally look up right-branch bundle blockage myself, but I learned after the mitral valve regurgitation thing that it will likely only make things worse, so I figured I might ask here instead.

Anyway, thanks for your time

Okay, I can't correctly discern from your posting, but if you're referring to the computer printout and any reference to right bundle branch block, you can relax. This is a common question or concern by many patients. The computer inside the ECG is equipped to interpret the ECG strip based upon algorithms programmed into its database.

The critical fact that you have to realize is that the computer only derives a differential diagnosis based upon the signals it receives and has no way of actually knowing the condition of your heart, the precise placement of the leads, medications, etc.

I don't even pay attention to what the computer has to offer in the way of a diagnosis. I read the data and base my decisions upon the patient's history and other diagnostic criteria. It's important for you to know that a multitude of factors can cause the ECG to interpret all sorts of diagnostic inferences, none of which should ever be considered to be accurate unless there is supoorting evidence and in your case, there is apparently none.

When the Vagus nerve inappropriately stimulates the heart, which you sense as a palpitation, the lungs, the larnyx and other areas can also be affected. This is why some folks are oftentimes compelled to cough in the presence of a palpitation or describe changes in their respiratory patterns. What your sensing is a disturbance of the nervous system in a manner that provokes an imposition upon the normal sinus rhythm of the heart. It will never cause you any harm and won't shorten your life span by even a moment. You'll be fine.

Best regards and Good Health

Yes, I would agree that some physicians have a lack of concern about health anxiety on the part of their patients, particularly in light of the fact that I have a good number of physicians as patients who, in my opinion, are among my most worrisome. You'd think there would be some insight in that regard, but alas I've yet to witness it.

If your cardiologist sent a report to your doctor, then you need to realize that this is your health information and not theirs. If you have questions or concerns, it's your right to know specifically what the report means and what options you have available. If your cardiologist refuses to elaborate, then find a more suitable physician. I have little regard for physicians who feel their compensation should be at a premium while their service time to patients is kept at a minimum. If you feel you need a better explanation then request one and don't let them steer you away with a loaded reply that merely says don't worry, you'll be fine. Ask for the specifics and even a copy of the report.

I do not recall you stating that you've been having episodes of ventricular tachycardia.  Could you elaborate on that for me please? I will tell you that in cases where this disorder requires pacing, we're speaking of heart rates exceeding 200 or excessive conduction delays and that sort of thing, not mere palpitations of the type you're experiencing.

If you care to obtain the exact diagnosis from the report, then I'll be glad to discuss it with you. It's important to know exactly what the parameters of the report depict. Certainly from the general response by your doctors, I do not believe there is evidence of pathology that would be placing you at any degree of risk. Physicians simply don't withold that sort of information or gamble with your healthcare in that regard.

You'll be fine. I'm sure your primary care doctor was merely following up on the report in the hopes of addressing any subsequent concerns you may have developed.

Best regards and Good Health