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Medical World Dr Rana Sanjay, Dr Rana S P Singh, Patna (2026)

27/05/2026

🤔 in ?
By🥼🩺 Dr. Rana S. P. Singh, MBBS, MD — Senior Physician, Patna

Hypertension has traditionally been considered an adult disease. However, emerging evidence shows that elevated blood pressure in children and adolescents is increasingly common and frequently underdiagnosed, undertreated, and underestimated. Childhood hypertension is now recognized as an important precursor of adult cardiovascular disease, stroke, and chronic kidney disease.

The Growing Burden of Pediatric Hypertension
Recent global and Indian studies reveal a worrying rise in pediatric hypertension, largely driven by obesity, sedentary lifestyle, excessive screen exposure, unhealthy dietary habits, stress, and poor sleep quality. The prevalence of hypertension among children and adolescents is estimated at approximately 3–5% globally, with even higher rates in overweight and obese children.

Indian school-based studies have reported prevalence figures ranging from 5% to over 20% in some urban populations.
Despite these rising numbers, routine blood pressure screening in children remains inconsistent in many healthcare settings.

🤔Why Is Pediatric Hypertension Often Missed?
👉Several factors contribute to underrecognition:
Blood pressure measurement is not routinely performed in all pediatric visits.
Pediatric BP interpretation is more complex because it depends on age, s*x, and height percentiles rather than fixed adult cutoffs.

Many hypertensive children are asymptomatic.
Lack of awareness among parents and even healthcare providers delays diagnosis.
White coat hypertension and masked hypertension may complicate assessment.

According to current pediatric guidelines, annual BP screening should begin from 3 years of age, and earlier in high-risk children such as those with obesity, renal disease, prematurity, diabetes, or congenital heart disease.

Long-Term Consequences
Persistent hypertension in childhood is not benign. Studies demonstrate early target-organ damage including:
Left ventricular hypertrophy
Vascular stiffness
Retinal changes
Renal injury
Increased lifetime cardiovascular risk
Elevated childhood BP often tracks into adulthood, making early identification crucial.

🤔Is It Undertreated?
👉Yes — evidence strongly suggests that pediatric hypertension remains undertreated worldwide.
Even after diagnosis, many children do not receive structured follow-up, lifestyle counseling, or appropriate pharmacological therapy when indicated. Lifestyle interventions remain the first-line strategy:
Weight reduction
Regular physical activity
Reduced salt intake
Limiting sugary beverages and processed foods
Adequate sleep
Reduced screen time
Pharmacologic treatment is necessary in selected cases, especially when hypertension is severe, symptomatic, secondary, associated with organ damage, or persistent despite lifestyle modification.

The Need for Greater Awareness
Pediatric hypertension should no longer be viewed as rare. Early screening programs in schools and clinics, parental education, and improved physician awareness are essential to prevent future cardiovascular morbidity.
Routine pediatric blood pressure assessment must become as standard as measuring temperature or weight. Detecting hypertension early in life offers an opportunity to alter the trajectory of cardiovascular disease before irreversible damage occurs.
👌Conclusion
Hypertension in children is an emerging public health challenge. Although its prevalence is steadily increasing, diagnosis and treatment remain inadequate in many settings. Greater awareness, early screening, lifestyle intervention, and timely treatment are essential to reduce the long-term burden of cardiovascular and renal disease.
The future of adult cardiovascular health may depend significantly on how effectively we recognize and manage hypertension during childhood today.

✒️🦁Lion DR RANA SANJAY PRATAP SINGH alias Dr. Rana S. P. Singh, MBBS, MD
Senior Physician, Patna

🦁DC 👉 FIRST AID EDUCATION AND EMERGENCY RELIEF⚡ LIONS CLUB INTERNATIONAL DISTRICT 322E

#बिहार

23/05/2026

Early Detection of Type 1 Diabetes in Children is Feasible from Routine Pediatric Care

Scientific Article
By🥼🩺🦁 Dr. Rana S. P. Singh, MBBS, MD
Senior Physician & Diabetologist, Patna

Early detection of Type 1 Diabetes (T1D) in children through routine pediatric care is increasingly recognized as both feasible and clinically valuable. Recent international studies demonstrate that screening children during regular pediatric visits can identify pre-symptomatic stages of T1D long before severe complications such as diabetic ketoacidosis (DKA) develop.

Type 1 Diabetes is an autoimmune disorder in which pancreatic beta cells are progressively destroyed, leading to insulin deficiency. Many children remain undiagnosed until they present with acute symptoms including excessive thirst, weight loss, vomiting, dehydration, or even life-threatening DKA. Early-stage identification through autoantibody screening provides a valuable opportunity for monitoring, education, and timely intervention.

👉Most Children With Early-Stage Type 1 Diabetes Do Not Have a Family History of the Disease
At the first screening, 590 children were found to have early-stage type 1 diabetes – corresponding to around 0.3 percent of the children screened. During follow-up, 212 of these children progressed to stage 3 type 1 diabetes. This represents 81 percent of the children who went on to develop clinical type 1 diabetes. After five years, the probability of progressing from an early stage to clinical type 1 diabetes was 36.2 percent. The research showed that while children with a first-degree relative with type 1 diabetes have a higher risk of developing type 1 diabetes, most of the children who develop stage 3 type 1 diabetes have no family history of the disease. Therefore, screening should not be limited to children with a family history of type 1 diabetes. Additionally, once an early stage has been diagnosed, the researchers observed no differences in disease progression in children with and without a family history.
A new finding is that the disease progresses at a similar rate across stages. The progression to advanced stages was around 20 percent every year in children who had stage 1 or stage 2 disease.

Screening Strategy
The current evidence supports screening for islet autoantibodies during routine pediatric healthcare visits. The major autoantibodies assessed include:
Insulin Autoantibodies (IAA)
Glutamic Acid Decarboxylase Antibodies (GAD65)
IA-2 Antibodies
Zinc Transporter 8 Antibodies (ZnT8)
Children with two or more positive islet autoantibodies are considered at high risk for progression to clinical Type 1 Diabetes.
Autoimmune Progression Concept

A large German population-based study involving more than 220,000 children reported that approximately 0.3% of screened children had early-stage T1D, and nearly 36.2% progressed to insulin-dependent Stage 3 disease within five years.

Clinical Benefits of Early Detection
1. Prevention of Diabetic Ketoacidosis (DKA)
Children identified early show significantly lower rates of DKA at diagnosis compared with unscreened children.

2. Better Glycemic Status at Diagnosis
Screen-detected children demonstrate:
Lower HbA1c levels
Better preserved beta-cell function
Reduced metabolic derangement
Lower insulin requirements initially

3. Family Education and Psychological Preparedness
Parents receive counseling regarding symptoms, glucose monitoring, nutrition, and follow-up planning, reducing anxiety and emergency presentations.
4. Opportunities for Preventive Therapies
Early identification may allow enrollment into immunomodulatory or preventive intervention trials before complete beta-cell destruction occurs.

Feasibility in Routine Pediatric Practice
Evidence from the Fr1da Study in Germany and the ELSA program in the UK confirms that population-based screening can be effectively integrated into everyday pediatric healthcare systems. Pediatricians successfully performed capillary blood sampling during regular check-ups with good family acceptance and operational feasibility.

International collaborative programs such as EDENT1FI are now expanding pediatric T1D screening across Europe using standardized screening pathways in primary healthcare settings.

Routine pediatric screening for Type 1 Diabetes has the potential to:
Reduce emergency hospitalizations
Lower healthcare costs related to DKA
Improve long-term outcomes
Increase public awareness of childhood diabetes
Support precision preventive medicine
Importantly, many children who develop T1D have no family history, suggesting that screening should not be restricted only to high-risk families.

👉Conclusion
Current scientific evidence strongly supports the feasibility and clinical importance of early detection of Type 1 Diabetes through routine pediatric care. Autoantibody-based screening during childhood health visits can identify at-risk children before symptomatic disease develops, enabling early monitoring, prevention of DKA, improved metabolic outcomes, and better family preparedness. Integration of such screening programs into routine pediatric practice may represent a major advancement in preventive diabetology and child healthcare worldwide.

🦁Lion DR RANA SANJAY PRATAP SINGH
( Dr RANA SP SINGH MBBS MD senior physician and diabetologist Patna Bihar 🇮🇳 India 🪷)

🦁DC 👉FIRST AID EDUCATION AND EMERGENCY RELIEF ⚡ LIONS CLUB INTERNATIONAL DISTRICT 322E

#बिहार

22/05/2026

🤔Overlap Between Familial Hyperlipidemia and Atherogenic Diabetic Dyslipidemia: Clinical Approach

✒️🥼🩺By Dr. Rana S. P. Singh
MBBS, MD – Senior Physician & Diabetologist, Patna

👉Introduction
Atherogenic diabetic dyslipidemia and familial hyperlipidemia frequently coexist in clinical practice, especially among patients with type 2 diabetes mellitus (T2DM). This overlap substantially increases the risk of premature atherosclerotic cardiovascular disease (ASCVD), myocardial infarction, stroke, and peripheral vascular disease.
Diabetic dyslipidemia is typically characterized by:
Elevated triglycerides (TG)
Low HDL cholesterol
Small dense LDL particles
Familial hyperlipidemia, especially familial hypercholesterolemia (FH) or familial combined hyperlipidemia (FCHL), is genetically determined and often presents with markedly elevated LDL-C and premature ASCVD.

When both disorders coexist, the lipid abnormalities become more aggressive and difficult to manage.
Pathophysiological Overlap
In diabetic dyslipidemia, insulin resistance leads to:
Increased lipolysis
Excess hepatic VLDL production
Hypertriglyceridemia
Formation of small dense LDL particles
In familial hyperlipidemia, genetic defects impair LDL clearance, leading to persistent LDL accumulation.

The coexistence of these mechanisms creates:
Severe mixed dyslipidemia
Accelerated endothelial dysfunction
Heightened inflammatory response
Rapid progression of atherosclerosis
Clinical Clues Suggesting Overlap
The possibility of familial dyslipidemia should be suspected in diabetic patients with:
LDL-C persistently >190 mg/dL
Strong family history of premature CAD
Tendon xanthomas or corneal arcus
Mixed hyperlipidemia despite glycemic control
Premature ASCVD at young age
Very high ApoB or non-HDL cholesterol
Familial combined hyperlipidemia is particularly common and may mimic diabetic dyslipidemia.

Diagnostic Approach
1. Complete Lipid Profiling
Recommended investigations include:
Total cholesterol
LDL-C
HDL-C
Triglycerides
Non-HDL cholesterol
ApoB
Lipoprotein(a)
2. Family Screening
Cascade screening among first-degree relatives is essential in suspected familial disorders.
3. Evaluate Secondary Factors
Assess for:
Poor glycemic control
Hypothyroidism
Nephrotic syndrome
Obesity
Alcohol excess
Drug-induced dyslipidemia
Therapeutic Approach
1. Lifestyle Intervention
Lifestyle modification remains foundational:
Mediterranean or DASH diet
Reduction in saturated and trans fats
Weight reduction
Regular aerobic exercise
Smoking cessation
Even modest weight reduction improves insulin resistance and lipid abnormalities.

2. Aggressive Glycemic Control
Improved glycemic control reduces:
Hepatic VLDL synthesis
Triglycerides
Small dense LDL formation
Agents with cardiometabolic benefits include:
SGLT2 inhibitors
GLP-1 receptor agonists
3. Statin Therapy: Cornerstone Treatment
LDL reduction remains the primary target.
Most patients with overlap syndrome require:
High-intensity statins
≥50% LDL-C reduction
Examples:
Atorvastatin 40–80 mg
Rosuvastatin 20–40 mg
Current guidelines recommend intensive lipid lowering in diabetic patients with familial dyslipidemia due to extremely high ASCVD risk.

4. Combination Lipid-Lowering Therapy
If LDL goals are not achieved:
Add ezetimibe
Consider PCSK9 inhibitors in very high-risk individuals
For persistent hypertriglyceridemia:
Fenofibrate
Icosapent ethyl (EPA)
Combination therapy may be necessary in mixed dyslipidemia.

5. Treatment Targets
Modern recommendations favor:
LDL-C

21/05/2026

Acute Coronary Syndrome Without Chest Pain in a High-Risk Patient:
A Case Report of Atypical Presentation and Diagnostic Challenge
Authors
✒️🥼🩺🦁Dr. Rana SP Singh, MBBS, MD
Senior Physician & Diabetologist, Patna, Bihar, India

Abstract
Acute coronary syndrome (ACS) classically presents with retrosternal chest pain; however, atypical presentations are common in elderly individuals, diabetic patients, and those with multiple cardiovascular risk factors. Such atypical manifestations may delay diagnosis and treatment, thereby increasing morbidity and mortality. We report a case of a high-risk diabetic patient who presented without chest pain but was subsequently diagnosed with non-ST elevation acute coronary syndrome (NSTE-ACS). Early clinical suspicion, electrocardiographic evaluation, and cardiac biomarker testing facilitated timely diagnosis and management. This case emphasizes the importance of maintaining a high index of suspicion for ACS in high-risk populations even in the absence of classical symptoms.
Keywords: Acute coronary syndrome, atypical presentation, diabetes mellitus, silent ischemia, non-ST elevation myocardial infarction, cardiovascular risk

Introduction
Acute coronary syndrome encompasses a spectrum of conditions resulting from acute myocardial ischemia and includes unstable angina, NSTEMI, and STEMI. Chest pain remains the hallmark presenting symptom; however, nearly one-third of patients—particularly elderly individuals and those with diabetes mellitus—may present atypically or without chest pain.
Diabetic autonomic neuropathy, altered pain perception, and coexisting comorbidities contribute to silent or atypical myocardial ischemia. Such presentations frequently lead to delayed diagnosis and poor outcomes. Recognition of these non-classical manifestations is essential in clinical practice, especially in resource-limited settings where diagnostic delays are common.

This report discusses a high-risk patient presenting without chest pain who was eventually diagnosed with ACS.
Case Presentation
A 68-year-old male presented to the emergency department with complaints of sudden onset breathlessness, generalized weakness, excessive sweating, and mild epigastric discomfort for approximately four hours. There was no history of chest pain, chest heaviness, radiation of pain, or palpitations.
The patient was a known case of:
Type 2 diabetes mellitus for 15 years
Hypertension for 12 years
Dyslipidemia
Former smoker with a 25-pack-year history
There was no prior documented history of coronary artery disease.

Clinical Examination
On examination:
Blood pressure: 150/90 mmHg
Pulse rate: 104/min, regular
Respiratory rate: 24/min
Oxygen saturation: 94% on room air
Temperature: Afebrile
Cardiovascular examination revealed tachycardia without murmurs. Bilateral basal crepitations were present on respiratory examination.
Investigations
Electrocardiogram (ECG)
ECG demonstrated:
ST-segment depression in leads V4–V6
T-wave inversion in inferior leads
Sinus tachycardia
Cardiac Biomarkers
Troponin-I: Positive
CK-MB: Elevated
Laboratory Findings
HbA1c: 8.9%
Random blood glucose: 248 mg/dL
Serum creatinine: 1.4 mg/dL
LDL cholesterol: 156 mg/dL
Echocardiography
2D echocardiography revealed:
Mild left ventricular dysfunction
Hypokinesia of the inferolateral wall
Ejection fraction approximately 45%
Diagnosis
Based on clinical presentation, ECG changes, and elevated cardiac biomarkers, a diagnosis of:
Non-ST Elevation Acute Coronary Syndrome (NSTE-ACS)
was established.

Management
The patient was admitted to the coronary care unit and managed according to ACS protocol.
Treatment included:
Dual antiplatelet therapy (Aspirin + Clopidogrel/Ticagrelor)
High-intensity statin therapy
Low molecular weight heparin
Beta blockers
Intravenous nitrates
Oxygen supplementation
Glycemic control with insulin
Coronary angiography subsequently revealed:
Significant stenosis of the left anterior descending artery (LAD)
Moderate disease in the right coronary artery
Percutaneous coronary intervention (PCI) with stenting of the LAD was successfully performed.
Outcome and Follow-Up
The patient showed gradual clinical improvement with stabilization of hemodynamic parameters. He was discharged after five days in stable condition with advice regarding:
Strict glycemic control
Lifestyle modification
Cardiac rehabilitation
Regular cardiology follow-up
At one-month follow-up, the patient remained asymptomatic with improved exercise tolerance.

Discussion
ACS without chest pain represents a major diagnostic challenge. Atypical symptoms such as dyspnea, diaphoresis, fatigue, nausea, syncope, or epigastric discomfort may be the only presenting features.
Diabetes mellitus is strongly associated with silent ischemia due to autonomic neuropathy affecting cardiac pain perception. Elderly patients frequently demonstrate reduced pain sensitivity and atypical symptomatology.
Studies have shown that patients presenting without chest pain:
Experience delayed diagnosis
Receive less aggressive therapy
Have higher mortality rates
In this case, the absence of chest pain could easily have led to misdiagnosis. Prompt ECG and biomarker assessment were crucial in identifying myocardial ischemia.
This case reinforces several important clinical principles:
High-risk patients may not present with classical ACS symptoms.
Dyspnea and diaphoresis in diabetic patients should raise suspicion for ACS.
Early ECG and troponin testing are essential in atypical presentations.
Timely intervention significantly improves outcomes.
👉Conclusion
Acute coronary syndrome may present without chest pain, particularly in elderly diabetic patients with multiple cardiovascular risk factors. Clinicians must maintain a high index of suspicion when evaluating atypical symptoms such as unexplained dyspnea, sweating, or epigastric discomfort. Early recognition and prompt management are essential to reduce morbidity and mortality associated with missed or delayed diagnosis.

👌Learning Points
ACS can occur without chest pain.
Diabetes mellitus predisposes to silent myocardial ischemia.
Dyspnea and diaphoresis may represent anginal equivalents.
Early ECG and troponin testing should be performed in high-risk patients.
Prompt diagnosis and revascularization improve prognosis.

🦁Lion DR RANA SANJAY PRATAP SINGH
(Dr Rana SP Singh senior physician and diabetologist Patna Bihar 🇮🇳 India 🪷)

🦁DC 👉FIRST AID EDUCATION AND EMERGENCY RELIEF⚡ LIONS CLUB INTERNATIONAL DISTRICT 322E
#बिहार

19/05/2026

"Beyond HbA1c – How to Personalise Glycemic Targets in Older Adults"

Scientific Article
By Dr. RANA S. P. SINGH, MBBS, MD
Senior Physician & Diabetologist, Patna

Diabetes management in older adults has evolved significantly over the past decade. Traditional diabetes care focused primarily on achieving a universal HbA1c target, often below 7%. However, growing clinical evidence now supports a more individualized approach in elderly patients, where treatment goals are tailored according to functional status, comorbidities, cognitive health, frailty, and life expectancy.

Introduction
Older adults with diabetes represent a highly heterogeneous population. Some elderly individuals remain physically active and cognitively intact, while others suffer from frailty, cardiovascular disease, renal impairment, or dementia. Therefore, a “one-size-fits-all” glycemic target may expose vulnerable patients to unnecessary risks, especially hypoglycemia. Modern diabetology emphasizes patient-centered glycemic goals rather than rigid HbA1c thresholds.

Understanding HbA1c
HbA1c reflects the average blood glucose level over approximately three months and remains an important tool in diabetes management.

However, HbA1c alone does not capture:
Glycemic variability
Risk of hypoglycemia
Functional limitations
Cognitive decline
Quality of life
Frailty and nutritional status
In older adults, these factors are often more clinically relevant than strict numerical glucose control.

Why Personalisation Matters
Intensive glycemic control in elderly patients may lead to:
Severe hypoglycemia
Falls and fractures
Cardiac arrhythmias
Cognitive impairment
Hospitalization
Increased mortality
Large studies have demonstrated that very tight glucose targets may not provide meaningful cardiovascular benefit in frail older individuals, especially those with limited life expectancy.

Therefore, glycemic targets should be individualized according to:
Functional status
Presence of comorbidities
Cognitive ability
Risk of hypoglycemia
Duration of diabetes
Patient preference and quality of life
Recommended Individualized HbA1c Targets
Healthy Older Adults
For elderly patients with:
Good functional capacity
Intact cognition
Longer life expectancy
Recommended HbA1c target:

Older Adults with Multiple Comorbidities
For patients with:
Cardiovascular disease
Chronic kidney disease
Polypharmacy
Mild cognitive impairment
Recommended target:

Frail Elderly or Limited Life Expectancy
For patients with:
Advanced frailty
Dementia
Recurrent hypoglycemia
Limited survival expectancy
Recommended target:

These recommendations are supported by multiple international guidelines including the American Diabetes Association and geriatric diabetes consensus statements.

Beyond HbA1c: The Role of Continuous Glucose Monitoring (CGM)
Modern diabetes care increasingly incorporates Continuous Glucose Monitoring (CGM), especially in insulin-treated elderly patients.
CGM provides:
Time in Range (TIR)
Time Below Range (TBR)
Glycemic variability
Detection of nocturnal hypoglycemia
Recent studies suggest that CGM may provide safer and more practical glycemic assessment than HbA1c alone in older adults.

Medication Selection in Older Adults
Therapeutic choices should prioritize safety.
Preferred Agents
Metformin (when renal function permits)
DPP-4 inhibitors
SGLT2 inhibitors
GLP-1 receptor agonists
Agents Requiring Caution
Sulfonylureas
Intensive insulin regimens
These medications carry a higher risk of hypoglycemia in elderly populations.

Shared Decision-Making
Modern diabetes care encourages shared decision-making between physician, patient, and caregivers. Treatment goals should align with:
Patient values
Functional independence
Nutritional status
Economic considerations
Caregiver support
Clinical guidelines now emphasize individualized glucose targets over rigid HbA1c numbers.

👌Conclusion
Management of diabetes in older adults must move “beyond HbA1c.” Personalized glycemic targets improve safety, reduce hypoglycemia, preserve quality of life, and support holistic geriatric care. In elderly patients, the ultimate therapeutic objective is not merely achieving a number, but ensuring safer longevity, functional independence, and better overall well-being.

✒️Author
🥼🩺 Lion DR RANA SANJAY PRATAP SINGH (Dr. RANA S. P. SINGH, MBBS, MD
Senior Physician & Diabetologist
Patna, Bihar, India)

🦁DC 👉FIRST AID EDUCATION AND EMERGENCY RELIEF 👉 LIONS CLUB INTERNATIONAL DISTRICT 322E
#बिहार #पटना

14/05/2026

🤔What happens during an ECG?
👌Ten small sticky patches called electrodes are put on your arms, legs and chest. These are connected by wires to an ECG machine which picks up the electrical signals that make your heart beat. This electrical activity is recorded and printed onto paper. Below is what a normal ECG would like.
🤔How long will an ECG take?
The whole test takes a few minutes and is completely painless. You will need to lie still as moving can affect the results.
🤔When an ECG is used
An ECG is often used alongside other tests to help diagnose and monitor conditions affecting the heart.

It can be used to investigate symptoms of a possible heart problem, like:

chest pain
suddenly noticeable heartbeats (palpitations)
dizziness
shortness of breath
An ECG can help detect:

arrhythmias – where the heart beats too slowly, too quickly, or irregularly
coronary heart disease – where the heart’s blood supply is blocked or interrupted by a build-up of fatty substances
heart attacks – where the supply of blood to the heart is suddenly blocked
cardiomyopathy – where the heart walls become thickened or enlarged
A series of ECGs can also be taken over time to monitor a person already diagnosed with a heart condition or taking medication known to potentially affect the heart.

🤔What can an ECG show?
👌An ECG can help detect problems with your heart rate or heart rhythm. It can help doctors tell if you’re having a heart attack or if you’ve had a heart attack in the past.

An ECG is usually one of the first heart tests you'll have. It does have some limitations, so often you will have one or more other tests too. An abnormal ECG reading does not always mean there's something wrong with your heart.

👉Different types of ECG test
Exercise ECG
This is an ECG that is recorded while you're walking on a treadmill or cycling on an exercise bike. The aim of this test is to see how your heart works when you're more active.
24-hour ECG recording
Also called Holter monitoring or ambulatory ECG monitoring, this involves continuously recording your heart’s electrical activity for 24 to 48 hours, sometimes longer. This can help diagnose conditions such as atrial fibrillation or uncover the cause of palpitations, which do not happen all the time.
🤔What happens during a 24-hour ECG recording?
👌You’ll have electrodes put on your chest and the wires attached to these will be taped down.
You’ll wear a small portable recorder on a belt around your waist which the wires will lead to.
While you’re wearing the ECG recorder, you can do everything you would normally do except have a bath or shower.
It's safe and completely painless but some electrodes can be very sticky, so let the team know if you have sensitive skin.
When the test is finished, you’ll return the recorder to the hospital so the results can be analysed.
🤔Cardiac event recorders
👌If you have symptoms that do not happen frequently, your doctor might suggest having a cardiac event recorder or an implantable loop recorder (also known as ILR) inserted. This records the heart's activity for a longer period of time, or whenever symptoms occur.

An ILR is implanted under the skin on your chest in a minor surgical procedure done under local anaesthetic. An ILR can continuously monitor your heartbeat for up to three years and help find out what may be causing your symptoms, such as dizzy spells or blackouts.

This is particularly useful for people who have symptoms that have not been picked up through a standard ECG or Holter monitor.
🤔Key Components of an ECG ReportA standard 12-lead ECG report provides a snapshot of heart function:Heart Rate: Normal resting rate is 60–100 beats per minute (bpm).Heart Rhythm: Indicates if the heartbeat is regular (sinus rhythm) or irregular (arrhythmia).Axis: Evaluates the overall direction of the heart's electrical activity (normally -30° to +90°).Intervals (PR, QRS, QT): Measure the time it takes for electrical impulses to travel through the heart. Abnormal intervals can indicate heart block or increased stroke risk.ST Segment: Elevated or depressed ST segments can indicate a heart attack or ischemia.

✒️🥼🩺🦁Dr RANA SANJAY PRATAP SINGH alias DR RANA SP SINGH MBBS MD senior physician and diabetologist Patna Bihar 🇮🇳 India 🪷

🦁DC 👉FIRST AID EDUCATION AND EMERGENCY RELIEF ⚡LIONS CLUB INTERNATIONAL DISTRICT 322E

Medical World Dr Rana Sanjay

27/05/2026

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