Ping Howard [OT Medical Question]

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CatNipped - 27 Jun 2005 17:19 GMT

Howard, I've been meaning to ask you this for a while but kept forgetting...

A couple of years ago I had an ECG and the doctor said I had a brachial
branch blockage. He said it wasn't anything to worry about and made it
sound like it was something to do with the medical equipment rather than
something wrong with my heart (???). To be positive he had me go for a
nuclear stress test and eco-cardiogram. When I went back for the second
part of the nuclear stress test they said I didn't even have to have it.
That, and the echo-cardiogram, showed that my heart was perfect.

So, just what is a brachial branch blockage?

Thanks!

Hugs,

CatNipped

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Howard C. Berkowitz - 27 Jun 2005 18:10 GMT

> Howard, I've been meaning to ask you this for a while but kept
> forgetting...
[quoted text clipped - 14 lines]
>
> CatNipped

I'm a little puzzled. Could it have been bundle branch block? That is
part of the electrical conduction system of the heart; there's a right
and left bundle.

Offhand, brachial generally refers to structures in the shoulder that
may extend into the neck. The brachial nerve, for example, runs across
the top of the shoulder, and is most exposed in a spot called the
brachial notch -- which is about the place where Spock did the Vulcan
nerve pinch.

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CatNipped - 27 Jun 2005 19:51 GMT

> > Howard, I've been meaning to ask you this for a while but kept
> > forgetting...
[quoted text clipped - 24 lines]
> brachial notch -- which is about the place where Spock did the Vulcan
> nerve pinch.

LOL that's probably it - I just remember it being three "Bs"! ;> It was
the right side.

Hugs,

CatNipped

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Howard C. Berkowitz - 27 Jun 2005 20:51 GMT

> > > Howard, I've been meaning to ask you this for a while but kept
> > > forgetting...
[quoted text clipped - 37 lines]
>
> CatNipped

As long as your heart is using some of its backup mechanisms, such that
there was adequate stimulation to pump, there's no inherent danger. If a
block is causing you to skip beats, that's another matter.

Echocardiograms and heart scans don't particularly look for problems in
the conduction system of the heart. If there was any diagnostic concern,
the next step would be having you wear a Holter monitor -- essentially a
24-hour electrocardiogram.

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CatNipped - 27 Jun 2005 21:03 GMT

> > > > Howard, I've been meaning to ask you this for a while but kept
> > > > forgetting...
[quoted text clipped - 46 lines]
> the next step would be having you wear a Holter monitor -- essentially a
> 24-hour electrocardiogram.

Well, there are lots of times when my heart skips beats - sometimes to the
point where it makes me dizzy. But I just assumed this happens to everybody
since you hear about "heart palpitations" so much. And since I didn't know
to associate this with BBB I didn't mention it to my doctor (and why didn't
he ask??!) It also usually happens when I'm having bad allergy or asthma
problems (my chest will feel tight like I can't get enough air into my
lungs - so I assumed that was what caused my heart to skip beats.

It doesn't happen on any regular basis, though, so with my luck the Holter
monitor* wouldn't show a thing. I thought the nuclear stress test and
echocardiogram would have showed something if there was a problem!

* Funny this is the first time I'd seen the name written - I'd only heard it
before and I thought people were saying "halter" monitor since you wear it
like a halter! ;>

Hugs,

CatNipped

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Howard C. Berkowitz - 28 Jun 2005 01:47 GMT

> > > "Howard C. Berkowitz" <hcb@gettcomm.com> wrote in message

> Well, there are lots of times when my heart skips beats - sometimes to
> the
[quoted text clipped - 12 lines]
> monitor* wouldn't show a thing. I thought the nuclear stress test and
> echocardiogram would have showed something if there was a problem!

I found a veterinary site with a pretty good description:
http://www.lbah.com/heart/heartfindings.htm

Understand that ECG interpretation is an art, although we now have
pretty good computer interpretation. At one point, I was developing an
ECG simulator to test my understanding; this was at the Office of
Computer Assisted Education at George Washington Medical School. Yes, I
produced the basic patterns.

My mentor, an MD-PhD type, took me to the ICU, pointed at a heart
monitor, and said: "Tell me what's wrong." I looked at it for a while
and said "Can the monitor be broken?"

The real-world difficulty in interpreting ECGs is that the textbooks
deal with one abnormality at a time, but it's common to have multiple
abnormalities superimposed on the display. I'm out of practice -- and
it takes a lot -- to read complex ones.

> * Funny this is the first time I'd seen the name written - I'd only heard
> it
> before and I thought people were saying "halter" monitor since you wear
> it
> like a halter! ;>

No, I'm afraid it doesn't quite make it as that fashion accessory --
unless you consider five or so electrodes on the chest as sort of like a
chainmail bra. The monitor itself is about the size of a Walkman, and
people either use a shoulder strap or attach it to their belts so it
hangs at waist level. There's enough cable so that you just stick it
under your pillow.

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