Explain ECG result with QTC prolongation

Explain ECG result with QTC prolongation

Approach

- Introduction, set the scene

- Explain ECG and QTC prolongation in layman term

- Explore possible causes and associated symptoms of QTC prolongation

- Explain management plan

Explain ECG

Basically ECG is the recording of electrical current in the heart.

Our heart is made up of muscles that keep pumping to deliver blood throughout body.

The electrical current tells the heart when to pump and when to relax. Is that clear?

Explain ECG result and QTC prolongation

From your heart tracing, I get to know that your heart is beating 80 times in a minute. That is normal.

In addition the rhythm appears very regular so it looks good.

But there is something I need to highlight here, the gap between these two waves, we call this QT interval. Normal measurement should be less than 440 milliseconds but your reading is longer than it supposed.

That means your heart is taking longer to recharge itself in between the heartbeat.

Things we worry about, long TC interval can disturb your heart rhythm sometimes, and at worse case that can be life threatening.

But I wish to reassured you that this is detected early and we are here to discuss things we can do to keep you safe.

Explore possible causes

Would it alright I just need to ask a few question to figure out the possible causes

Do you have any physical illness at all? Any heart disease? High blood pressure? High cholesterol Diabetes? Are you on any medication apart from quetiapine? Do you smoke any cigarettes? Does anyone is your family have any heart disease?

It seems to me quetiapine is a possible reason leading up to your prolonged QT interval.

Explore symptoms

Have prolonged QT interval caused you any physical discomfort? Any chest pain? Any palpitation? Any difficulty breathing? Any light-headedness?

Explain management plan

We appreciate the fact that quetiapine is really an important medication to keep you well, But right now we need to prioritize your physical health given the life threatening nature of prolonged QT interval. We would like to recommend to withhold  quetiapine for time being till there is thorough workout from the cardiologist. Meanwhile, we will keep an close eye on your mental health well being. Would that be alright with you?

We will also speak to the cardiologist in order to get him to assess you urgently.

Way forward, we will consider to put you back on antipsychotic medication when you are medically stable . We have medication which is relatively safer to heart for example the aripiprazole which we can talk more in depth next time. Any question at all?

Mee Hoon Soup with Assorted Pork (猪肉粉)

Mee Hoon Soup with Assorted Pork (猪肉粉)

Restaurant Pudu Utama

RM 7.50 (with egg)

RM 6.50 (without egg)

 Soup is a bit of sweeten taste Big portion. 

Full of meat balls, fried pork oil, organs - liver, intestine, blah blah.

Full and satisfied!! 

Rate 3.6/5

I-Heritage Hotel

It is right behind Berjaya Time Square.

RM 31 per night, 4-beds mixed dormitory room with shared bathroom, with simple breakfast provided, I rate this hostel 4.2/5.

From ground floor walking up the staircase, going past the first floor, here is the look for the second floor.

   

There are washing machine, drinking water, weighing scale and full-length mirror in the second floor. During my stay, I was allocated to third floor aka the roof top.

To go up further from this staircase, here is the roof top area. I got room A. The main entrance is secured with electronic lock and access card while individual room is provided a key to enter. 

View from the roof top area. In front is Berjaya Time Square. The tall building next to it is the TRX tower which is currently under construction. Soon it will be the tallest building in Malaysia.

Here is my room. Two bunk beds to occupy 4 people. Each of us has a safe deposit box. 

Room is clean and tidy.

Mattress is quite thick and new, with curtain to cover each bed.

 

Well functioning aircon but it took 5 minutes to cool down the room (likely because my room was on 

the roof top).

Scene from the window

Wash room is available at roof top area. There is another one in second floor. It is clean and well maintained. Shampoo and towel are provided.

Common area is at the rooftop, where TV is available. Wifi signal is poor in the room. Here is place to get better wifi signal (not fast but functional). Thing I dislike is when there were people come here for smoking.

Basic breakfast - bread, egg, milk, tea, coffee, butter, biscit ect

 

Here is a convenient store .

Overall, I-heritage offers confortable room for those looking for good sleep overnight. It is located at the off road area thus avoiding noise at night. Plus points are good quality mattress, clean and tidy environment, cold air-con and friendly service crew. Despite not being luxurious, its price is cheap thus worth the value paid (do remember, it provides simple breakfast). Bad things about here, turtle speed wifi and steep staircase thus making it less suitable for old age. Recommended for solo back packers.